TY - JOUR T1 - Botulinum toxin for the treatment of sialorrhoea in ALS: serious side effects of a transductal approach JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 417 LP - 418 DO - 10.1136/jnnp.70.3.417 VL - 70 IS - 3 AU - M G M WINTERHOLLER AU - F J ERBGUTH AU - S WOLF AU - S KAT Y1 - 2001/03/01 UR - http://jnnp.bmj.com/content/70/3/417.abstract N2 - 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 ER -