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. 2019 Jun;8(1):155-160.
doi: 10.1007/s40120-018-0125-9. Epub 2019 Jan 8.

The Treatment of Hypersalivation in Rett Syndrome with Botulinum Toxin: Efficacy and Clinical Implications

Pia Bernardo  1   2 , Enza Raiano  3 , Gerarda Cappuccio  4 , Raffaele Dubbioso  3 , Carmela Bravaccio  4 , Emilia Vergara  5 , Silvio Peluso  3 , Fiore Manganelli  3 , Marcello Esposito  3
Affiliations

The Treatment of Hypersalivation in Rett Syndrome with Botulinum Toxin: Efficacy and Clinical Implications

Pia Bernardo et al. Neurol Ther. 2019 Jun.

Abstract

Introduction: Subjects with Rett syndrome (RS) develop invariably severe motor deterioration resulting in swallowing difficulties that may produce excessive drooling. Hypersalivation can cause discomfort due to hygienic problems and may complicate with oral and respiratory dysfunctions. The aim of this study is to evaluate the response to treatment with botulinum toxin (BTX) for hypersalivation and to identify possible benefits of saliva reduction on oral motor and respiratory disorders of patients with RS.

Methods: Five consecutive patients with RS and hypersalivation were treated with incobotulinumtoxin A injected in salivary glands with ultrasound guidance. Severity of excessive drooling was assessed with the Thomas-Stonell and Greenberg Scale (TGSC) and the clinical impact of the treatment was evaluated using three selected items of RS Assessment Rating Scale (R.A.R.S.): eating habits, dyspnoea and bruxism. Scale rating was performed before BTX injection (T0), 4 (T1) and 12 (T2) weeks after.

Results: Scores of TGSC and R.A.R.S. (for eating and bruxism) were reduced significantly after therapy at T1.

Conclusions: BTX treatment for sialorrhea in RS is effective in reducing saliva production and may also improve oral motor functions.

Keywords: Botulinum toxin; Bruxism; Drooling; Rett syndrome.

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Figures

Fig. 1
Fig. 1
Effect of BTX injections on clinical scores (TSGS, RARS eating, RARS dyspnoea, RARS bruxism) after 4 (T1) and 12 weeks (T2)
See this image and copyright information in PMC

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