Article

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.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith
Press.

Langue : ANGLAIS