Article Text

Botulinum toxin for the treatment of sialorrhoea in ALS: serious side effects of a transductal approach
  1. M G M WINTERHOLLER,
  2. F J ERBGUTH
  1. Department of Neurology, Friedrich-Alexander-Universität Erlangen, Schwabachanlage 6, D-91054 Erlangen, Germany
  2. Department of Otorhinolaryngology
  3. Department of Nuclear Medicine
  1. Dr M GM Winterholler, MD wiho.erlangen{at}t-online.de
  1. S WOLF
  1. Department of Neurology, Friedrich-Alexander-Universität Erlangen, Schwabachanlage 6, D-91054 Erlangen, Germany
  2. Department of Otorhinolaryngology
  3. Department of Nuclear Medicine
  1. Dr M GM Winterholler, MD wiho.erlangen{at}t-online.de
  1. S KAT
  1. Department of Neurology, Friedrich-Alexander-Universität Erlangen, Schwabachanlage 6, D-91054 Erlangen, Germany
  2. Department of Otorhinolaryngology
  3. Department of Nuclear Medicine
  1. Dr M GM Winterholler, MD wiho.erlangen{at}t-online.de

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

We have read with interest the article by Giesset al,1 which showed that botulinum toxin A (BoNT/A) might be a new treatment option for sialorrhoea in patients with bulbar palsy. We have recently conducted a similar study which was interrupted due to serious side effects.

In September 1998 we injected 25 MU Botox into the parotid glands of a 59 year old women who had ALS with pronounced bulbar palsy. We noticed a reduction of the sialorrhoea but facial weakness on the left side worsened significantly.

After this experience we developed a protocol for the treatment of sialorrhoea in patients with ALS with bulbar palsy by retrograde injection of BoNT/A through the salivary duct into the salivary glands. We chose the retrograde way of administration of BoNT/A for this pilot study because we thought that this technique would avoid facial weakness.

After informed consent the patients received 12.5 mouse units (MU) BoNT/A (BotoxR) retrogradly into each parotid and sublingual gland from a small catheter inserted into the salivary duct. Neurological examination and quantification …

Dr M Naumann naumann{at}mail.uni-wuerzburg.de

View Full Text