Randomized double-blind study of botulinum toxin type B for sialorrhea in ALS patients

Carlayne E. Jackson, Gary Gronseth, Jeffrey Rosenfeld, Richard J. Barohn, Richard Dubinsky, C. Blake Simpson, April Mcvey, Pamela P. Kittrell, Ruth King, Laura Herbelin, Robert Griggs, Rabi Tawil, Carlayne Jackson, John T. Kissel, Shree Pandya, Karen Downing, Michael Rose, Michael McDermott

Research output: Contribution to journalArticlepeer-review

100 Scopus citations


Twenty ALS patients with sialorrhea refractory to medical therapy were enrolled in this double-blind, randomized study to receive either 2,500 U of botulinum toxin type B (BTxb) or placebo into the bilateral parotid and submandibular glands using electromyographic guidance. Patients who received BTxb reported a global impression of improvement of 82% at 2 weeks compared to 38% of those who received placebo (P < 0.05). This significant effect was sustained at 4 weeks. At 12 weeks, 50% of patients who received BTxb continued to report improvement compared to 14% of those who received placebo. There were no significant adverse events, including dysphagia, in the BTxb group, and there was no significant increase in the rate of decline of vital capacity.

Original languageEnglish (US)
Pages (from-to)137-143
Number of pages7
JournalMuscle and Nerve
Issue number2
StatePublished - Feb 2009


  • Amyotrophic lateral sclerosis
  • Botulinum toxin
  • Drooling
  • Quality of life
  • Sialorrhea

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)


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