{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:04Z","timestamp":1787014084992,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,11,30]],"date-time":"2016-11-30T00:00:00Z","timestamp":1480464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      The aims of this study were: (1) to determine the incidence and nature of adverse effects on oral motor function after first injections of botulinum neurotoxin A (Bo\n                      <jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\n                      \u2010A) in submandibular glands for excessive drooling in children with central nervous system disorders; and (2) to identify independent predictors of these adverse effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      A cohort study involved 209 children (123 males, 86 females, aged 4\u201327y, median 8y 4mo), who received submandibular Bo\n                      <jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\n                      \u2010A injections for drooling. Adverse effects were categorized into swallowing, eating, drinking, articulation, and other problems. Univariable logistic regression was used to study differences in patients with and without adverse effects. Possible predictors were identified using multivariable logistic regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Transient adverse effects occurred in 33% of the 209 Bo\n                      <jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\n                      \u2010A treatments. Almost 80% of these were mild, versus 8.7% severe. Approximately 54% of the adverse effects spontaneously resolved within 4 weeks; 3% still existed after 32 weeks. A diagnosis of cerebral palsy, higher range of Bo\n                      <jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\n                      \u2010A dosage, and a pre\u2010treatment drooling quotient &lt;18% were found to be independent predictors of adverse effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>\n                      Before using submandibular Bo\n                      <jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\n                      \u2010A injections for drooling, potential adverse effects should be discussed. Oral motor function needs to be monitored, because existing dysphagia may be worsened. The identified clinical predictors could be helpful to optimize patient selection.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dmcn.13333","type":"journal-article","created":{"date-parts":[[2016,11,30]],"date-time":"2016-11-30T05:36:54Z","timestamp":1480484214000},"page":"531-537","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Negative effects of submandibular botulinum neurotoxin A injections on oral motor function in children with drooling due to central nervous system disorders"],"prefix":"10.1111","volume":"59","author":[{"given":"Karen","family":"van Hulst","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Donders Centre for Neuroscience Radboud University Medical Centre Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlyn V","family":"Kouwenberg","sequence":"additional","affiliation":[{"name":"Department 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