Efficacy and duration of botulinum toxin treatment for drooling in 131 children.

OBJECTIVE

To address the efficacy of botulinum toxin and the duration of its effect when used on a large scale for the treatment of drooling in children with neurological disorders.

DESIGN

Prospective cohort study.

SETTING

Academic multidisciplinary drooling clinic.

PATIENTS

A total of 131 children diagnosed as having cerebral palsy or another nonprogressive neurological disorder and who also have moderate to severe drooling.

INTERVENTION

Injection of botulinum toxin to the submandibular glands.

MAIN OUTCOME MEASURES

Direct observational drooling quotient (DQ) (0-100) and caretaker visual analog scale (VAS) scores (0-100).

RESULTS

A clinically notable response was found in 46.6% of children, reflected in a significant mean reduction in DQ from a baseline of 29 to 15 after 2 months and 19 after 8 months (P < .001). The mean VAS score decreased from 80 at baseline to 53 after 2 months and increased to 66 after 8 months (P < .001). Kaplan-Meier analysis showed that patients who initially responded to treatment experienced relapse after a median of 22 weeks (interquartile range, 20-33 weeks).

CONCLUSIONS

Our study provides further support for botulinum toxin's efficacy for treatment of drooling in approximately half of patients for a median of 22 weeks. Further optimization of patient selection should be an area of attention in future studies.