Humans ; Sialorrhea ; etiology ; therapy

OBJECTIVE: To compare the effect of combination of intradermal needling with oral motor therapy and simple oral motor therapy on salivation in children with cerebral palsy. METHODS: A total of 60 children with salivation in cerebral palsy were randomized into an observation group and a control group, 30 cases in each group. The observation group was treated with intradermal needling (kept for 24 hours each time at Jiache [ST 6], Dicang [ST 4], tongue three needles, etc. ) and oral motor therapy, while the control group was only given oral motor therapy. The intradermal needling was performed 3 times a week, and oral motor therapy was performed 5 times a week, 4 weeks as a course, totally 3 courses of treatment were required. The classification of teacher drooling scale (TDS), drooling severity and Kubota water swallow test, dysphagia disorders survey (DDS) score were compared before treatment and after 4, 8 and 12 weeks of treatment in both groups, and the clinical efficacy was evaluated. RESULTS: After 8 weeks of treatment in the observation group and after 12 weeks of treatment in the two groups, the classification of TDS and drooling severity were improved (P<0.05), and the observation group was better than the control group after 12 weeks of treatment (P<0.05). After 8 and 12 weeks of treatment, the DDS scores of oral period in the observation group were lower than those before treatment (P<0.05). The total effective rate in the observation group was 83.3% (25/30), which was higher than 53.3% (16/30) in the control group (P<0.05). CONCLUSION The combination of intradermal needling with oral motor therapy can improve salivation symptoms and swallowing function in children with cerebral palsy, the effect is better than oral motor therapy alone, and the effect is earlier.
Acupuncture Points ; Acupuncture Therapy ; Cerebral Palsy/therapy* ; Child ; Deglutition Disorders/therapy* ; Humans ; Salivation ; Sialorrhea/therapy* ; Treatment Outcome

A 43-year-old woman suffered from drooling and dysphagia after a stroke in the left posterior inferior cerebellar artery territory. Videofluoroscopic swallowing study showed compatible findings of cricopharyngeal dysphagia. Despite the injection of botulinum neurotoxin, no symptom improvement was achieved and pharyngeal dystonia was considered as the cause. Medications for dystonia dramatically helped with saliva control and resulted in a small improvement in the progression of food from the pharyngeal to esophageal phase. After adjusting the drug dose, the patient was able to perform social activities without drooling. Moreover, she could consume food orally; however, this was limited to small amounts of liquid, and the main method of nutrition support was via an orogastric tube. Therefore, we suggest that physicians should make a differential diagnosis of combined dystonia in patients complaining of dysphagia by esophageal manometry and electromyography.
Adult ; Arteries ; Deglutition ; Deglutition Disorders ; Diagnosis, Differential ; Drug Therapy ; Dystonia ; Electromyography ; Female ; Humans ; Manometry ; Methods ; Saliva ; Sialorrhea ; Stroke

Animals ; Botulinum Toxins ; adverse effects ; therapeutic use ; Bruxism ; drug therapy ; Dystonia ; drug therapy ; Humans ; Joint Dislocations ; drug therapy ; Sialorrhea ; drug therapy ; Temporomandibular Joint Disorders ; drug therapy

OBJECTIVETo determine the mechanism of inhibitory effect of botulinum toxin type A (BTX-A) on parotid gland secretion.

METHODSFemale Wistar rats (n = 18) were randomly divided into saline injection group (n = 6) and BTX-A injection group ( n = 12), respectively. 0.1 ml of saline was injected into left parotid gland and 2.5 U of BTX-A injected into right parotid gland. Rats were sacrificed at day 7, 12 and 35 post-injections respectively for morphology and vasoactive intestinal polypeptide (VIP) immunoreactivity of parotid gland.

RESULTSFollowing BTX-A injection, some atrophic cells and reduction of number of VIP-immunoreactive (VIP-IR) fibers were found in gland and tube at day 7 (P < 0.05); at day 12, there was more obvious reduction of VIP-IR fibers around tube and vessels and atrophy of cells in BTX-A injection gland than saline injection gland (P < 0.001); at day 35, the glandular cells and VIP-IR fibers were similar to saline injection group.

CONCLUSIONSBTX-A is effective for temporary elimination of hyperfunctioning sialorrhea via inhibition of VIP release which plays a key role in modulation of parotid glands secretion.

Animals ; Botulinum Toxins, Type A ; pharmacology ; Female ; Parotid Gland ; drug effects ; secretion ; Rats ; Rats, Wistar ; Sialorrhea ; drug therapy ; Vasoactive Intestinal Peptide ; secretion

OBJECTIVE[corrected] To evaluate efficacy and safety of botulinum toxin type B (BTX-B) in treatment of movement disorders including blepharospasm, oromandibular dystonia, hemifacial spasm, tremor, tics, and hypersecretory disorders such as sialorrhea and hyperhidrosis.

METHODSA retrospective study of BTX-B injections in treatment of 58 patients with various neurological disorders was performed. The mean follow-up time was 0.9 +/- 0.8 years. Results of the first and last treatment of patients with at least 3 injection sessions were compared.

RESULTSThe response of 58 patients to a total of 157 BTX-B treatment sessions was analyzed. Of the 157 treatment sessions, 120 sessions (76.4%) resulted in moderate or marked improvement while 17 sessions (10.8%) had no response. The clinical benefits after BTX-B treatment lasted an average of 14 weeks. Of the 41 patients with at least 3 injection sessions (mean 10 +/- 8.6), most patients needed increased dosage upon the last session compared to the first session. Nineteen patients (32.8%) with 27 sessions (17.2%) reported adverse effects with BTX-B treatment.

CONCLUSIONSThough most patients require increased dosage to maintain effective response after repeated injections, BTX-B is an effective and safe treatment drug for a variety of movement disorders, as well as drooling and hyperhidrosis.

Anti-Dyskinesia Agents ; administration & dosage ; therapeutic use ; Blepharospasm ; drug therapy ; Botulinum Toxins ; administration & dosage ; therapeutic use ; Botulinum Toxins, Type A ; Follow-Up Studies ; Humans ; Hyperhidrosis ; drug therapy ; Injections ; Meige Syndrome ; drug therapy ; Movement Disorders ; drug therapy ; Retrospective Studies ; Sialorrhea ; drug therapy ; Torticollis ; drug therapy

Hepatic encephalopathy is a complex neuropsychiatric syndrome with protean clinical manifestations. Recently, we experienced a atypical case of hepatic encephalopathy who chiefly complained of extrapyramidal symptoms. A 41-year-old female had a 4-year history of liver cirrhosis that was caused by hepatitis B virus. Three days before admission, she began to feel resting hand tremor, facial diplegia, dysarthria, drooling and swallowing difficulty. On physical examination, cogwheel rigidity of upper extremities, stooping posture and loss of arm swing on walk were noted, but all sensory functions were intact. MRI showed abnormally increased signal on T1-weighted images in the corpus striatum, mainly in the putamen and globus pallidus, and the head of the caudate nucleus. Her neurological and radiological findings were consistent with manganese intoxication, but she had no history of manganese exposure. The extrapyramidal symptoms and signs were successfully controlled after the administration of anti-parkinsonian drugs, but it was uncertain whether this improvement was a result of drug therapy or not.
Adult ; Arm ; Caudate Nucleus ; Corpus Striatum ; Deglutition ; DNA ; Drug Therapy ; Dysarthria ; Female ; Globus Pallidus ; Hand ; Head ; Hepatic Encephalopathy* ; Hepatitis B ; Hepatitis B virus ; Hepatitis Viruses ; Humans ; Lamivudine ; Liver Cirrhosis ; Magnetic Resonance Imaging ; Manganese ; Muscle Rigidity ; Physical Examination ; Posture ; Putamen ; Sensation ; Sialorrhea ; Tremor ; Upper Extremity