Toxicon : official journal of the International Society on Toxinology
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In recent years, Botulinum Toxin has been shown to be efficacious and safe in the treatment of sialorrhea, but scanty data are available on its long term use. The aim of this study was to investigate adverse events, discriminate differences in safety, and evaluate the efficacy of long-term use of both abobotulinumtoxinA and rimabotulinumtoxinB ultrasound-guided injections for sialorrhea in a retrospective trial. Moreover we review the literature on this topic. ⋯ Both 250 U abobotulinumtoxinA and 2500 U rimabotulinumtoxinB administered by ultrasound-guided intrasalivary gland injection are safe and effective in treating sialorrhea, even in long-term follow-up. Older age is significantly associated with longer benefit duration. Parkinson's Disease patients showed a more favorable safety-efficacy ratio than did Amyotrophic Lateral Sclerosis patients, due to lower adverse events (p = NS) and longer benefit duration (p < 0.001).
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Since its discovery, Onabotulinum toxins have been tried for the treatment of various head, neck and face pain syndromes. The end result of controlled clinical trials was that there was not clear evidence for use in many of the common primary and secondary headaches. In chronic migraine, affecting 1-2% of the population, a fixed site and fixed dose treatment approach was shown to be superior to placebo and was approved for use. In this review, evidence for that use and the history leading to it is described.