einstein. 2005; 3(3):174-178

Injection of botulinum toxin type a to reduce saliva in patients with neurological diseases Aplicação de toxina botulínica tipo A para reduzir a saliva em pacientes com doenças neurológicas Dayse Manrique* Objective: To demonstrate the effect of local injection of Botox ® in patients with neurological diseases, following our protocol for the treatment of sialorrhea. Study design: clinical prospective study. Methods: Twenty-one patients with neurological diseases seen at the Otorhinolaryngology of the Associação de Assistência à Criança Deficiente. They were all submitted to local injection of Botox ® in salivary glands and followed up for one year. The protocol consists of a clinical questionnaire about inability to swallow saliva and its repercussions in general health and quality of life. Patients must not have periodontal disease or intolerance to adverse effects of anticholinergic agents and must not have used Botox ® at least in the last six months. The injection was ultrasonographically guided and the dose was 30 U in one site of the submandibular glands, and 20 U in two sites in each parotid gland. Results: Twenty-one patients with sialorrhea resulting from several neurological diseases (chronic encephalopathy, Parkinson’s disease, amyotrophic lateral sclerosis, neuromuscular diseases, cerebral tumor, trauma), aged 2 to 66 years old, were submitted to Botox ® injection in their salivary glands. We observed a markedly improvement of sialorrhea in all but one patient. Seventeen patients had no complaints of sialorrhea or saliva aspiration for approximately four months with good repercussion in their quality of life. No patient presented local or systemic effects with local injection of Botox®. Conclusion: the injection of Botox ® as indicated in the present study was able to reduce sialorrhea resulting from several neurological conditions