Botox helps children with cerebral palsy

Children with cerebral palsy often suffer from uncontrolled drooling, but this can be reduced with an injection of Botox, researchers report

They also found that a scopolamine patch - sometimes used for controlling motion sickness - helps reduce drooling, too, but the Botox treatments were associated with fewer and less serious side effects.

The findings are based on a study of 45 cerebral palsy patients with severe drooling who were treated with both agents. Several standard scales were used to assess drooling at the start of the study and after each therapy.

Botox treatment involved injections into the salivary glands, which had to be done under general anesthesia. The scopolamine patch was applied to the skin behind the ear.

Both Botox and scopolamine reduced drooling, lead author Dr. Peter H. Jongerius, from University Medical Centre St. Radboud in Nijmegen, the Netherlands, and colleagues report in the medical journal Pediatrics.

Following a Botox injection, the greatest reduction in drooling occurred 2 to 8 weeks later. The investigators note that a single injection of Botox eased the problem for up to 24 weeks to a degree that was comparable to regular use of the scopolamine patch.

Overall, 49 percent and 53 percent of the children responded to Botox and scopolamine, respectively.

However, about 71 percent of them experienced moderate to severe adverse effects with scopolamine, such as dry mouth, restlessness, blurry vision, or confusion. In contrast, only minor side effects were seen with Botox, such as mild difficulty swallowing.

Summing up the pros and cons, Jongerius' team concludes: "A disadvantage in the treatment with scopolamine is the high percentage of observed adverse reactions, whereas Botox injections need general anesthesia in children."

SOURCE: Pediatrics, September 2004.