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Updated: Jun 10, 2026

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
Published on: November 9, 2016
Botulinum toxin improves dysphagia associated with multiple sclerosis
D A Restivo1, R Marchese-Ragona, F Patti
1Department of Neurology, Nuovo Garibaldi Hospital, Catania, Italy. darestivo@libero.it
Objective:
To evaluate the efficacy of botulinum neurotoxin type A (BoNT/A) for severe oro-pharyngeal dysphagia associated with multiple sclerosis (MS).
Patients And Methods:
BoNT/A was injected percutaneously into the hyperactive cricopharyngeal muscle of 14 dysphagic MS patients under electromyographic control. Patients were evaluated by videofluoroscopic and electromyographic examinations and by the Penetration/Aspiration Scale (PAS), at week 1, 4, 12, 16, 18, and 24 after BoNT/A injection.
Results:
All patients showed a significant improvement in all the swallowing outcome measures.
Conclusion:
No specific treatment for oro-pharyngeal dysphagia related to MS has been described to date. Our preliminary findings suggest a potential benefit from BoNT/A treatment in MS patients with dysphagia associated with upper esophageal sphincter hyperactivity.
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