Botulinum toxin B reduces sialorrhea in parkinsonism

Authors

  • Brad A. Racette MD,

    Corresponding author
    1. Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA (Neurology), Washington University School of Medicine, St. Louis, Missouri, USA
    2. American Parkinson Disease Association Advanced Center for Parkinson Research, Washington University School of Medicine, St. Louis, Missouri, USA
    3. Huntington Disease Society of America Center of Excellence
    • Washington University School of Medicine, 660 South Euclid Ave., Box 8111, St. Louis, MO 63110
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  • Laura Good BA,

    1. Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA (Neurology), Washington University School of Medicine, St. Louis, Missouri, USA
    2. American Parkinson Disease Association Advanced Center for Parkinson Research, Washington University School of Medicine, St. Louis, Missouri, USA
    3. Huntington Disease Society of America Center of Excellence
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  • Sandy Sagitto RN,

    1. Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA (Neurology), Washington University School of Medicine, St. Louis, Missouri, USA
    2. American Parkinson Disease Association Advanced Center for Parkinson Research, Washington University School of Medicine, St. Louis, Missouri, USA
    3. Huntington Disease Society of America Center of Excellence
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  • Joel S. Perlmutter MD

    1. Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA (Neurology), Washington University School of Medicine, St. Louis, Missouri, USA
    2. American Parkinson Disease Association Advanced Center for Parkinson Research, Washington University School of Medicine, St. Louis, Missouri, USA
    3. Huntington Disease Society of America Center of Excellence
    4. Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
    5. Department of Anatomy and Neurobiology, Washington University School of Medicine, St. Louis, Missouri, USA
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  • Disclosure: Elan pharmaceuticals provided botulinum toxin B samples at no charge but provided no other support for this study. Dr. Racette has served as a paid consultant for both Allergan and Elan Pharmaceuticals in the last year.

Abstract

We report on our open-label experience with botulinum toxin B for the treatment of severe sialorrhea associated with parkinsonism. Nine adult patients with parkinsonism and medically intractable sialorrhea were treated with botulinum toxin B (1,000 units into each parotid gland using superficial landmarks). After treatment, patients experienced a 61% mean subjective improvement and a 42% mean reduction of quantitative saliva production. There were no adverse effects seen in any subjects. Mean peak benefit from injections lasted 14 weeks. We conclude that denervation of salivary glands with botulinum toxin B produces excellent reduction of excessive salivation associated with parkinsonism. © 2003 Movement Disorder Society

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