Randomized double‐blind study of botulinum toxin type B for sialorrhea in als patients

Jackson, Carlayne E.; Gronseth, Gary S.; Rosenfeld, Jeffrey; Barohn, Richard J.; Dubinsky, Richard; Simpson, C. Blake; McVey, April; Kittrell, Pamela; King, R.; Herbelin, Laura

doi:10.1002/mus.21213

Cited by 130 publications

(90 citation statements)

References 19 publications

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“…12 In a small trial, amitriptyline and botulinum toxin type A (BTxA) seemed equally effective, although 3 of 5 patients treated with amitriptyline experienced side effects (Class III). 13 In a double-blind, controlled trial of botulinum toxin type B (BTxB) in 20 patients with ALS with refractory sialorrhea (Class I), 14 patients were randomized to 2,500 U of BTxB or placebo into bilateral parotid and submandibular glands. Treated patients reported a global improvement of 82% at 2 and 4 weeks compared to 38% in placebo ( p Ͻ 0.05).…”

Section: What Are the Most Effective Treatments For Sialorrhea?mentioning

confidence: 99%

Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Multidisciplinary care, symptom management, and cognitive/behavioral impairment (an evidence-based review)

Miller¹,

Jackson²,

Kasarskis³

et al. 2009

Neurology

569

417

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Objective: To systematically review evidence bearing on the management of patients with amyotrophic lateral sclerosis (ALS). Methods:The authors analyzed studies from 1998 to 2007 to update the 1999 practice parameter. Topics covered in this section include breaking the news, multidisciplinary clinics, symptom management, cognitive and behavioral impairment, communication, and palliative care for patients with ALS.

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Section: What Are the Most Effective Treatments For Sialorrhea?mentioning

confidence: 99%

Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Multidisciplinary care, symptom management, and cognitive/behavioral impairment (an evidence-based review)

Miller¹,

Jackson²,

Kasarskis³

et al. 2009

Neurology

569

417

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“…At 12 weeks, 50% of patients receiving BTxb continued to report improvement compared to 14% receiving placebo. There were no significant adverse events, including dysphagia, in the BTxb group and no significant increase in the rate of decline of vital capacity 89 .…”

Section: Sialorrhea and Thick Phlegmmentioning

confidence: 80%

Amyotrophic lateral sclerosis (ALS): three letters that change the people's life. For ever

Oliveira

Pereira

2009

Arq. Neuro-Psiquiatr.

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-Amyotrophic lateral sclerosis (Als) is a neurodegenerative disease affecting the motor nervous system. it causes progressive and cumulative physical disabilities in patients, and leads to eventual death due to respiratory muscle failure. The disease is diverse in its presentation, course, and progression. We do not yet fully understand the cause or causes of the disease, nor the mechanisms for its progression; thus, we lack effective means for treating this disease. currently, we rely on a multidisciplinary approach to symptomatically manage and care for patients who have Als. Although amyotrophic lateral sclerosis and its variants are readily recognized by neurologists, about 10% of patients are misdiagnosed, and delays in diagnosis are common. prompt diagnosis, sensitive communication of the diagnosis, the involvement of the patient and their family, and a positive care plan are prerequisites for good clinical management. A multidisciplinary, palliative approach can prolong survival and maintain quality of life. Treatment with riluzole improves survival but has a marginal effect on the rate of functional deterioration, whereas non-invasive ventilation prolongs survival and improves or maintains quality of life. in this review, we discuss the diagnosis, management, and how to cope with impaired function and end of life on the basis of our experience, the opinions of experts, existing guidelines, and clinical trials. Multiple problems require a multidisciplinary approach including aggressive symptomatic management, rehabilitation to maintain motor function, nutritional support (enteric feeding, gastrostomy), respiratory support (non invasive home ventilation, invasive ventilation, tracheotomy), augmentative communication devices, palliative care, psychological support for both patients and families (because family members so often play a central role in management and care), communication between the care team, the patient and his or her family, and recognition of the clinical and social effects of cognitive impairment. social, bioethical, and financial issues as well as advance directives should be addressed. A plethora of evidence-based guidelines should be compiled into an internationally agreed guideline of best practice. The multidisciplinary team has changed the history of disease, with still no curative therapy available.KeY WorDs: amyotrophic lateral sclerosis, diagnosis, treatment.Esclerose lateral amiotrófica (ELA): três letras que mudam a vida de uma pessoa. Para sempre.Resumo -A esclerose lateral amiotrófica (elA) é doença neurodegenerativa comprometendo o sistema nervoso motor. ela causa comprometimento físico, progressivo e acumulativo, com óbito freqüentemente decorrente de falência respiratória. A enfermidade apresenta características diversas nas formas de apresentação, curso e progressão. Não entendemos ainda a causa ou causas dessa enfermidade, nem os mecanismos que regem a sua progressão; assim, tratamentos efetivos não são, até o momento, conhecidos. Atualmente, recomenda-se que os...

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“…The adjuvant treatment includes analgesics, anti-inflammatory and antispasmodics. [1,2,4,23,24] The patient quality of life depends strongly on medical, psychosocial and existential accompany in life. Fatigue, depression, anxiety and hopelessness are common among these patients.…”

Section: Als Managementmentioning

confidence: 99%

Epidemiology and Clinical Description of Amyotrophic Lateral Sclerosis in Low Income Setting: A Syndrome with Short Survival

Assogba¹,

Brah²,

Kombaté³

et al. 2015

AJPN

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Abstract:Background: Amyotrophic lateral sclerosis (ALS) is a degenerative motor neuron disease. It evolves to loss of autonomy and death. Objective: To describe the cases of ALS clinically definite observed in hospital field. Patients and methods: The retrospective study has covered a period of 10 years (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)) and a total of 10,128 patient's files were analyzed. The neurology department of our level 3 hospital has located the current study. Six patients with no particular medical history have been reported. The inclusion patients are cases where the diagnosis of ALS was clinically definite according to the modified El Escorial classification. About 978 of likely, possible and probable cases of ALS were not included. Results: The mean age was 49 years (24 and 67), all males, with a frequency of 0.59 ‰ and an incidence rate of 0.6 cases per year. The clinical signs were marked by the pyramidal syndrome and peripheral neuropathic motor syndrome. MRI or CT scan signs were marked by the bulbar light atrophy. EMG had shown spontaneous activities with reinnervation signs. The histology exam has found neurogenic fascicular atrophy. The average duration of progression of the disease from the diagnostic to death was 17.6 months (6 to 36). The median of survival all cases combined was 42 weeks. Symptomatic treatment was associated to rehabilitation. Riluzole has been established despite its high cost, but without success. Conclusion: This observation highlighted the major difficulties encountered in the management of ALS and its increasing frequency in south Saharan Africa.

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Randomized double‐blind study of botulinum toxin type B for sialorrhea in als patients

Cited by 130 publications

References 19 publications

Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Multidisciplinary care, symptom management, and cognitive/behavioral impairment (an evidence-based review)

Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Multidisciplinary care, symptom management, and cognitive/behavioral impairment (an evidence-based review)

Amyotrophic lateral sclerosis (ALS): three letters that change the people's life. For ever

Epidemiology and Clinical Description of Amyotrophic Lateral Sclerosis in Low Income Setting: A Syndrome with Short Survival

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