Document Type : original article


1 Department of Pediatrics, School of medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Pediatric Neurology Ward, Mashhad University of Medical Sciences

3 Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

4 Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

5 Assistant Professor of Pediatric. Mashhad University of Medical Sciences, Mashhad, Iran.

6 Clinical Research Development Center, Akbar Hospital, Faculty of Medicine, Mashhad University of medical sciences, Mashhad, Iran

7 Assistant Prof of Pediatric Pulmonology, Mashhad University of Medical Sciences


Background: Cerebral palsy stands as the main cause of mobility disability in childhood, and the accompanying sialorrhea exacerbates health and psychological issues for both the child and the family. We aimed to assess the effect of botulinum toxin type A on reducing sialorrhea in children with cerebral palsy.
Methods: This self-controlled clinical trial was executed among children afflicted with cerebral palsy. The Teacher Drooling Scale was used as the data collection tool. The intervention involved the administration of botulinum toxin A, with a dosage ranging from 30 to 50 units in each parotid gland, skillfully guided by a radiologist using ultrasound. Sialorrhea scores were compared before and after the injection.
Results: Our study included 21 children with cerebral palsy and sialorrhea. After the two post-injection weeks, a noteworthy drop was observed in the sialorrhea score (4.10±0.831) compared to the pre-injection score (4.71±0.463). The sialorrhea score until the ninth month after injection (1.121±3.43) was still significantly lower than the score before injection.
Conclusion: The injection of botulinum toxin A emerges as a potent medication, significantly curtailing the drooling among patients with cerebral palsy. This finding can be used to prevent aspiration pneumonia and reduce social and psychological complications in this population.


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