Botulinum toxin treatment of secretory disorders.
Identifieur interne : 000D83 ( Ncbi/Checkpoint ); précédent : 000D82; suivant : 000D84Botulinum toxin treatment of secretory disorders.
Auteurs : Markus Naumann [Allemagne] ; Wolfgang JostSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2004.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Anti-Dyskinesia Agents, Botulinum Toxins.
- drug therapy : Hyperhidrosis, Parkinson Disease, Salivary Gland Diseases, Sialorrhea.
- innervation : Axilla, Hand.
- Humans.
Abstract
Botulinum neurotoxin serotype A (BoNT/A) has revolutionised the treatment of a variety of autonomic hypersecretory disorders. Several open and controlled studies indicate that BoNT/A is a safe and effective treatment for focal hyperhidrosis of the axillae and palms, for gustatory sweating, and for some other rare conditions associated with focal hyperhidrosis. There is class I evidence for the efficacy of botulinum toxin in axillary hyperhidrosis and class II evidence for palmar hyperhidrosis and gustatory sweating. BoNT/A has the potential to replace current invasive and surgical techniques and should at least be considered as a viable alternative. The results of pilot studies to treat sialorrhea are encouraging. However, the optimal dose, best mode of application, side effects, and duration of BoNT/A action in this condition remain uncertain. We need further formal clinical trials to evaluate risks and benefits of BoNT/A for palliative treatment in of sialorrhea in Parkinson's disease and in bulbar amyotrophic lateral sclerosis. Based on the few reports published, BoNT/A injections into the lacrimal gland for hyperlacrimation may be an elegant method to treat this sometimes disabling condition. Again, larger studies are needed to evaluate the risks and long-term benefits of this treatment option.
DOI: 10.1002/mds.20067
PubMed: 15027066
Affiliations:
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pubmed:15027066Le document en format XML
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<affiliation wicri:level="3"><nlm:affiliation>Department of Neurology, University of Würzburg, Würzburg, Germany. naumann@mail.uni-wuerzburg.de</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Neurology, University of Würzburg, Würzburg</wicri:regionArea>
<placeName><region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Basse-Franconie</region>
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<author><name sortKey="Jost, Wolfgang" sort="Jost, Wolfgang" uniqKey="Jost W" first="Wolfgang" last="Jost">Wolfgang Jost</name>
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<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
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<term>Botulinum Toxins (therapeutic use)</term>
<term>Hand (innervation)</term>
<term>Humans</term>
<term>Hyperhidrosis (drug therapy)</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Salivary Gland Diseases (drug therapy)</term>
<term>Sialorrhea (drug therapy)</term>
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<term>Salivary Gland Diseases</term>
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<keywords scheme="MESH" qualifier="innervation" xml:lang="en"><term>Axilla</term>
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<front><div type="abstract" xml:lang="en">Botulinum neurotoxin serotype A (BoNT/A) has revolutionised the treatment of a variety of autonomic hypersecretory disorders. Several open and controlled studies indicate that BoNT/A is a safe and effective treatment for focal hyperhidrosis of the axillae and palms, for gustatory sweating, and for some other rare conditions associated with focal hyperhidrosis. There is class I evidence for the efficacy of botulinum toxin in axillary hyperhidrosis and class II evidence for palmar hyperhidrosis and gustatory sweating. BoNT/A has the potential to replace current invasive and surgical techniques and should at least be considered as a viable alternative. The results of pilot studies to treat sialorrhea are encouraging. However, the optimal dose, best mode of application, side effects, and duration of BoNT/A action in this condition remain uncertain. We need further formal clinical trials to evaluate risks and benefits of BoNT/A for palliative treatment in of sialorrhea in Parkinson's disease and in bulbar amyotrophic lateral sclerosis. Based on the few reports published, BoNT/A injections into the lacrimal gland for hyperlacrimation may be an elegant method to treat this sometimes disabling condition. Again, larger studies are needed to evaluate the risks and long-term benefits of this treatment option.</div>
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