Botulinum Toxin A in the Treatment of Sialorrhea in Children with Cerebral Palsy

以A型肉毒桿菌毒素治療腦性麻痺患者流口水

10.6558/MTJM.2006.11(4).8

楊佩瑜(Pei-Yu Yang)；韓亭怡(Ting-I Han)；周立偉(Li-Wei Chou)；周恆正(Herng-Jeng Jou)；周怡君(Yi-Chun Chou)；孟乃欣(Nai-Hsin Meng)

A型肉毒桿菌毒素 ； 腦性麻痺 ； 流口水 ； 超音波定位 ； botulinum toxin A ； cerebral palsy ； sialorrhea ； ultrasound guidance

Mid-Taiwan Journal of Medicine

11卷4期（2006 / 12 / 01）

261 - 266

英文

過去對於因吞嚥障礙而造成的流口水問題，並沒有令人滿意的治療方法。最近有研究利用A型肉毒桿菌毒素來阻斷唾液腺的神經支配，但目前應用於腦性麻痺患者的研究較少。本文報告四位腦性麻痺患者以A型肉毒桿菌毒素治療流口水，有別於過去研究使用的固定劑量注射，我們首次根據患者的體重給予不同劑量（每公斤體重2單位肉毒桿菌毒素），並配合超音波定位。經過20週的追蹤，四位患者皆達到滿意的治療效果，療效維持可達16至20週，且無併發症發生。

Sialorrhea is commonly associated with many neurological and systemic conditions. For children and young adults with cerebral palsy, sialorrhea may cause embarrassment and social isolation. Current medical management used for sialorrhea is unsatisfactory. Preliminary studies in adults with sialorrhea have demonstrated that botulinum toxin A as an effective treatment; however, no studies have defined the optimal dose and the duration of botulinum toxin A's effects on sialorrhea in patients with cerebral palsy. We present four patients with cerebral palsy who received botulinum toxin A treatment for sialorrhea. Under ultrasound guidance, body weight-related dosage of botulinum toxin A was injected bilaterally into the parotid glands. All four patients reported distinct improvement within the first 2 weeks following toxin injection. Duration of the toxin's effect varied from 16 to 20 weeks. There were no therapeutic side effects.