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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.
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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