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Is injection of botulinum toxin type A effective in the treatment of drooling in children with cerebral palsy?
  1. L Vaile,
  2. F Finlay
  1. Community Child Health, NHS House, Newbridge Hill, Bath BA1 3QE, UK; louise.vaile@banes-pct.nhs.uk

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You see a 12 year old boy with cerebral palsy (CP) in outpatients. His mother is concerned about his drooling. He has tried hyoscine patches with little effect. His mother has heard a radio programme about botulinum toxin (BTX-A) injections and asks you whether it would be beneficial.

Structured clinical question

In children with cerebral palsy [patient] is botulinum toxin A [intervention] effective in the treatment of drooling [outcome]?

Search strategy and outcome

Secondary sources: Cochrane Database: 0.

Primary Sources: Medline 1966 to present: botulinum AND drooling AND cerebral palsy; botulinum AND sialorrhoea AND cerebral palsy. Limit = English language. Ten articles; six relevant (two papers by Jongerius et al2,3 were published in different journals but relate to the same study group of children). See table 3.

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Table 3

 Effect of botulinum toxin on drooling in children with cerebral palsy

Commentary

Drooling is a significant problem in many children with cerebral palsy. In addition to the physical effects, drooling causes psychosocial morbidity by detracting from physical appearance …

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