Treatment of therapy-resistant sialorrhea with transdermal scopolamine in a 10-year-old girl with Wolf-Hirschhorn syndrome

Case Report: Wolf-Hirschhorn syndrome is caused by a deletion of the band 4p16.3. A 10-year-old girl diagnosed in 2004 with Wolf-Hirschhorn syndrome had classic symptoms as well as strong sialorrhea caused by hypertrophy of the salivary glands. Even with increasing variable doses of Botulinum toxin A and B, symptoms could not be controlled. Treatment with glycopyrrolate showed no effect either. The application of transdermal scopolamine even in low doses of 1.5 mg/day, led to a decrease of salivation by 40%.