Jun Jin-Sun, Seo Han Gil, Lee Soon-Tae, Chu Kon, Lee Sang Kun
Department of Neurology Seoul National University Hospital Seoul South Korea.
Department of Rehabilitation Medicine Seoul National University Hospital Seoul South Korea.
Ann Clin Transl Neurol. 2017 Sep 26;4(11):830-834. doi: 10.1002/acn3.467. eCollection 2017 Nov.
Hypersalivation is one of the intractable symptoms of anti--methyl-d-aspartate receptor (NMDAR) encephalitis. While anticholinergic medications partially improve the hypersalivation, they can aggravate the autonomic dysfunctions associated with anti-NMDAR encephalitis. Thus, we investigated the efficacy and safety of botulinum toxin type A injection on hypersalivation refractory to anticholinergics in six patients with anti-NMDAR encephalitis. Hypersalivation was well-controlled without remarkable adverse reaction over 16 weeks after botulinum toxin type A, although two patients were reinjected at 12 weeks due to reaggravation of hypersalivation. Our findings suggest that botulinum toxin type A might be a better choice than anticholinergics for management of hypersalivation in patients with anti-NMDAR encephalitis.
流涎过多是抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎的难治性症状之一。虽然抗胆碱能药物可部分改善流涎过多症状，但它们会加重与抗NMDAR脑炎相关的自主神经功能障碍。因此，我们调查了A型肉毒毒素注射治疗6例抗NMDAR脑炎患者中对抗胆碱能药物难治的流涎过多症状的疗效和安全性。注射A型肉毒毒素后16周内，流涎过多症状得到良好控制，且无明显不良反应，不过有2例患者因流涎过多症状复发在12周时再次接受注射。我们的研究结果表明，对于抗NMDAR脑炎患者的流涎过多症状管理，A型肉毒毒素可能是比抗胆碱能药物更好的选择。
