Article

The aims of this study were: (1) to determine the incidence and nature of
adverse effects on oral motor function after first injections of botulinum
neurotoxin A (BoNT-A) in submandibular glands for excessive drooling in children
with central nervous system disorders; and (2) to identify independent predictors
of these adverse effects. METHOD: A cohort study involved 209 children (123
males, 86 females, aged 4-27y, median 8y 4mo), who received submandibular BoNT-A
injections for drooling. Adverse effects were categorized into swallowing,
eating, drinking, articulation, and other problems. Univariable logistic
regression was used to study differences in patients with and without adverse
effects. Possible predictors were identified using multivariable logistic
regression. RESULTS: Transient adverse effects occurred in 33% of the 209 BoNT-A
treatments. Almost 80% of these were mild, versus 8.7% severe. Approximately 54%
of the adverse effects spontaneously resolved within 4 weeks; 3% still existed
after 32 weeks. A diagnosis of cerebral palsy, higher range of BoNT-A dosage, and
a pre-treatment drooling quotient <18% were found to be independent predictors of
adverse effects. INTERPRETATION: Before using submandibular BoNT-A injections for
drooling, potential adverse effects should be discussed. Oral motor function
needs to be monitored, because existing dysphagia may be worsened. The identified
clinical predictors could be helpful to optimize patient selection.
CI - (c) 2016 The Authors. Developmental Medicine & Child Neurology published by John
Wiley & Sons Ltd on behalf of Mac Keith Press.

Langue : ANGLAIS