Quantitative reduction of saliva production in two ALS patients with intraglandular injections of botulinum toxin.

A quantitative reduction of saliva production to less than 10% of original flow rate could be achieved by intraglandular injections of a total of 300 units of botulinum toxin (type DysportR) in two amyotrophic lateral sclerosis (ALS) patients. The treatment effect lasted for at least 8 weeks and increased after repeated injections. All major salivary glands were injected. Masseter strength did not decrease intolerably. This treatment can therefore be recommended even in ALS patients with paresis of the bulbar musculature.