Safety and administration of treatment with botulinum neurotoxin for sialorrhoea in ALS patients: Review of the literature and a proposal for tailored treatment

Abstract

Botulinum neurotoxin (BoNT) is a second-line treatment of sialorrhoea in ALS (amyotrophic lateral sclerosis) patients. This article is a review of the published literature concerning safety and administration of this treatment to ALS patients.

A PubMed search was performed. All original publications on BoNT treatment of sialorrhoea in ALS patients were included in the review. Only a few adverse events were observed concerning treatment with BoNT. The studies performed to date have applied different treatment strategies with different dosages. In conclusion, BoNT treatment for sialorrhoea in ALS patients is safe with few adverse effects. The authors advocate for the implementation of a personalized treatment strategy. Special precautions must be taken when patients do not have the assistance of a ventilator and a feeding tube.

Key words::

• ALS
• sialorrhoea
• drooling
• botulinum neurotoxin
• treatment

Disclosure of interest: Morten Stokholm and Carsten Bisgaard report no conflict of interests. Ole Jakob Vilholm has participated in studies and/or received grants and funding from the following companies: Allergan, Ipsen, and Eisai. The authors alone are responsible for the content and writing of the paper.