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    Salivary gland botulinum toxin injections for drooling in children with cerebral palsy and neurodevelopmental disability: A systematic review

    Access Status
    Open access via publisher
    Authors
    Rodwell, K.
    Edwards, P.
    Ware, R.
    Boyd, Roslyn
    Date
    2012
    Type
    Journal Article
    
    Metadata
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    Citation
    Rodwell, K. and Edwards, P. and Ware, R. and Boyd, R. 2012. Salivary gland botulinum toxin injections for drooling in children with cerebral palsy and neurodevelopmental disability: A systematic review. Developmental Medicine and Child Neurology. 54 (11): pp. 977-987.
    Source Title
    Developmental Medicine and Child Neurology
    DOI
    10.1111/j.1469-8749.2012.04370.x
    ISSN
    0012-1622
    School
    School of Occupational Therapy and Social Work
    URI
    http://hdl.handle.net/20.500.11937/28713
    Collection
    • Curtin Research Publications
    Abstract

    Aim The aim of this paper was to systematically review the efficacy and safety of botulinum toxin (BoNT) injections to the salivary glands to treat drooling in children with cerebral palsy and neurodevelopmental disability. Method A systematic search of The Cochrane Central Register of Controlled Trials, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), EMBASE, and the Physiotherapy Evidence Database (PEDro) was conducted (up to 1 October 2011). Data sources included published randomized controlled trials (RCTs) and prospective studies. Results Sixteen studies met inclusion criteria. Three outcome measures support the effectiveness of BoNT for drooling. One RCT found an almost 30% reduction in the impact of drooling on patients' lives, as measured by the Drooling Impact Scale (mean difference -27.45; 95% confidence interval [CI] -35.28 to -19.62). There were sufficient data to pool results on one outcome measure, the Drooling Frequency and Severity Scale, which supports this result (mean difference -2.71; 95% CI -4.82 to -0.60; p<0.001). There was a significant reduction in the observed number of bibs required per day. The incidence of adverse events ranged from 2 to 41%, but was inconsistently reported. One trial was terminated early because of adverse events. Interpretation BoNT is an effective, temporary treatment for sialorrhoea in children with cerebral palsy. Benefits need to be weighed against the potential for serious adverse events. More studies are needed to address the safety of BoNT and to compare BoNT with other treatment options for drooling. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

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