Management of drooling in cerebral palsy

Owen, Seward E.; Stern, L. M.

doi:10.1097/00004356-199206000-00011

Cited by 9 publications

(5 citation statements)

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“…In a case series of N-of-1 trials involving three children with cerebral palsy and excess drooling, one child discontinued benztropine because of an intolerable visual disturbance despite significant improvement in drooling. 35 The frequent adverse effects associated with medications used to treat drooling in children have resulted in some clinicians electing to avoid this form of therapy altogether. Over a 30 year experience, Crysdale et al 1 chose to medicate only 14 of 1487 children, preferring to treat the bulk of patients through surgical intervention instead.…”

Section: Discussionmentioning

confidence: 99%

Sublingual Atropine Drops for the Treatment of Pediatric Sialorrhea

Rapoport

2010

Journal of Pain and Symptom Management

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Excess oral secretions or sialorrhea is a common problem affecting children and adults with neurological disorders, as well as those approaching the end of life because of a variety of underlying illnesses. Systemic anticholinergic medications are often prescribed in an attempt to improve quality of life and reduce complications; yet, response rates are variable, and a sizable proportion of patients discontinue these drugs as a result of intolerable side effects. This report describes the successful use of a local treatment, sublingually delivered ophthalmic atropine drops, to reduce sialorrhea in a child receiving palliative care. In addition, medical evidence for the safety and efficacy of traditionally prescribed systemic medications for the treatment of pediatric sialorrhea is reviewed.

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Section: Discussionmentioning

confidence: 99%

Sublingual Atropine Drops for the Treatment of Pediatric Sialorrhea

Rapoport

2010

Journal of Pain and Symptom Management

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“…Three were randomised controlledl trials (RCTs), [5][6][7] three were cohort studies, [8][9][10] and one was an experimental design. 11 Two RCTs 5 7 and two cohort studies 8 10 did not meet the proposed methodological criteria. In order to provide a complete overview of the available literature, all outcomes are listed in table 2.…”

Section: Results Of the Literature Searchmentioning

confidence: 99%

“…Owen and Stern 11 investigated the effect of benztropine using a "within subject design". The methodological quality of the study was correct.…”

Section: (3) (3) (3) (3) (3) (3) 10 Co-intervention Checkedmentioning

confidence: 99%

A systematic review for evidence of efficacy of anticholinergic drugs to treat drooling

Jongerius

2003

Archives of Disease in Childhood

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“…Previous studies have investigated benztropine, benzhexol hydrochloride, glycopyrrolate, and scopolamine patches for their usefulness in treating paediatric drooling. All have demonstrated reductions in drooling, with response rates varying between 52% and 95%.…”

Section: Discussionmentioning

confidence: 99%

Anticholinergic medications for reducing drooling in children with developmental disability

Reid

Westbury

Guzys

et al. 2019

Develop Med Child Neuro

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DISDrooling Impact Scale AIM To determine: the effectiveness of three anticholinergic medications in reducing drooling in children with developmental disabilities (such as cerebral palsy, intellectual disability, and autism spectrum disorder), the frequency and nature of side effects, and their impact on treatment discontinuation.METHOD After prescription of benzhexol hydrochloride, glycopyrrolate, or scopolamine patches at a tertiary saliva control clinic, all carers of 110 consecutive, eligible patients were recruited over a 5-year period. They provided data for 52 weeks, or until drug discontinuation, on compliance, drooling, adverse effects, and reasons for cessation. We evaluated and compared best drooling response, side effects, and drug cessation rates using survival analysis, and the effect of baseline variables on the discontinuation rate using proportional hazards regression.RESULTS Among 110 participants (71 males, 39 females; mean age 8y 5mo [SD 4y 3mo], range 1y 11mo-18y 11mo), benzhexol, glycopyrrolate, and scopolamine were prescribed 81, 62, and 17 times respectively, with respective response rates of 85%, 75%, and 65%. Poor head control and poor oromotor function were predictive of poor response. Side effects frequently prompted drug cessation in males more than females (hazard ratio 1.8 [95% confidence interval 1.0-3.2], p=0.048). Glycopyrrolate had the fewest side effects.INTERPRETATION Benzhexol, glycopyrrolate, and scopolamine reduce drooling, but improvement is offset by adverse side effects. Overall, glycopyrrolate performs best.

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Management of drooling in cerebral palsy

Cited by 9 publications

References 0 publications

Sublingual Atropine Drops for the Treatment of Pediatric Sialorrhea

Sublingual Atropine Drops for the Treatment of Pediatric Sialorrhea

A systematic review for evidence of efficacy of anticholinergic drugs to treat drooling

Anticholinergic medications for reducing drooling in children with developmental disability

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