Dysphagia in cerebral palsy

Abstract

Abstract. Feeding problemsare often present in children with neuromotor impairment: dysphagia is usuallyseen in the most severe form of cerebral palsy and it’s defined as thedifficulty with any of the four phases of swallowing. Clinical consequences aremalnutrition and recurrent chest infections that reduce expected duration andquality of life. In order to prevent these consequences it’s important todetect with clinical and instrumental examinations dysphagia symptoms and totreat them. Clinical evaluation focuses mainly on the oral stage of dysphagiai.e. patterns of oral dysfunction but is not able to assess accurately thepharyngeal and esophageal phases that can be studied with instrumental evaluationlike videofluoroscopy. Videofluoroscopy data provide the basis for an objectiveplanning of the treatment only if combined with careful clinical examination.Treatment options include rehabilitative measures such as postural managementand food texture modification and in the most severe cases surgical procedures.Key words: Cerebral palsy, dysphagia

Keywords

• Cerebral palsy, dysphagia

Kaynakça

1. Bax MC, Flodmark O, Tydeman C. Definition and classification of cerebral palsy. From syndrome toward disease. Dev Med Child Neurol Suppl 2007; 109: 39-41.
2. Hagberg B, Hagberg G, Olow I, von Wendt L. The changing panorama of cerebral palsy in Sweden. VII. Prevalence and origin in the birth year period 1987- 90. Acta Paediatr 1996; 85: 954-960.
3. Gisel EG, Alphonce E. Classification of eating impairments based on eating efficiency in children with cerebral palsy. Dysphagia 1995; 10: 268-274.
4. Rogers B, Arvedson J, Buck G, Smart P, Msall M. Characteristics of dysphagia in children with cerebral palsy. Dysphagia 1994; 9: 69-73.
5. Loughlin GM. Respiratory consequences of dysfunctional swallowing and aspiration. Dysphagia 1989; 3: 126-130.
6. DeMatteo C, Matovich D, Hjartarson A. Comparison of clinical and videofluoroscopic evaluation of children with feeding and swallowing difficulties. Dev Med Child Neurol 2005; 47: 149-157.
7. Gisel EG, Patrick J. Identification of children with cerebral palsy unable to maintain a normal nutritional state. Lancet 1988; 1: 283-286.
8. Cass H, Wallis C, Ryan M, Reilly S, McHugh K. Assessing pulmonary consequences of dysphagia in children with neurological disabilities: when to intervene? Dev Med Child Neurol 2005; 47: 347-352.

9. Kenny DJ, Koheil RM, Greenberg J, et al. Development of a multidisciplinary feeding profile for children who are dependent feeders. Dysphagia 1989; 4: 16-28.
10. Casas MJ, McPherson KA, Kenny DJ. Durational aspects of oral swallow in neurologically normal children and children with cerebral palsy: an ultrasound investigation. Dysphagia 1995; 10: 155- 159.
11. Selley WG, Parrott LC, Lethbridge PC, et al. Objective measures of dysphagia complexity in children related to suckle feeding histories, gestational ages, and classification of their cerebral palsy. Dysphagia 2001; 16: 200-207.
12. Tuchman DN. Cough, choke, sputter: the evaluation of the child with dysfunctional swallowing. Dysphagia 1989; 3: 111-116.
13. Waterman ET, Koltai PJ, Downey JC, Cacace AT. Swallowing disorders in a population of children with cerebral palsy. Int J Pediatr Otorhinolaryngol 1992; 24: 63-71.
14. Gisel EG. Oral-motor skills following sensorimotor intervention in the moderately eating-impaired child with cerebral palsy. Dysphagia 1994; 9: 180-192.
15. Rempel G, Moussavi Z. The effect of viscosity on the breath-swallow pattern of young people with cerebral palsy. Dysphagia 2005; 20: 108-112.
16. Griggs CA, Jones PM, Lee RE. Videofluoroscopic investigation of feeding disorders of children with multiple handicap. Dev Med Child Neurol 1989; 31: 303-308.
17. Morgan AT, Omahoney R, Francis H. The use of pulse oximetry as a screening assessment for paediatric neurogenic dysphagia. Dev Neurorehabil 2008; 11: 25-38.
18. Mirrett PL, Riski JE, Glascott J, Johnson V. Videofluoroscopic assessment of dysphagia in children with severe spastic cerebral palsy. Dysphagia 1994; 9: 174-179.
19. Sorin R, Somers S, Austin W, Bester S. The influence of videofluoroscopy on the management of the dysphagic patient. Dysphagia 1988; 2: 127-135.
20. Judd PL, Kenny DJ, Koheil R, Milner M, Moran R. The multidisciplinary feeding profile: a statistically based protocol for assessment of dependent feeders. Dysphagia 1989; 4: 29-34.
21. Selley WG, Parrott LC, Lethbridge PC, et al. Objective measures of dysphagia complexity in children related to suckle feeding histories, gestational ages, and classification of their cerebral palsy. Dysphagia 2001; 16: 200-207.
22. Arvedson J, Rogers B, Buck G, Smart P, Msall M. Silent aspiration prominent in children with dysphagia. Int J Pediatr Otorhinolaryngol 1994; 28: 173-181.
23. Lefton-Greif MA, Carroll JL, Loughlin GM. Long- term follow-up of oropharyngeal dysphagia in children without apparent risk factors. Pediatr Pulmonol 2006; 41: 1040-1048.
24. Gisel EG. Effect of oral sensorimotor treatment on measures of growth and efficiency of eating in the moderately eating-impaired child with cerebral palsy. Dysphagia 1996; 11: 48-58.
25. Gisel EG, Applegate-Ferrante T, Benson J, Bosma JF. Oral-motor skills following sensorimotor therapy in two groups of moderately dysphagic children with cerebral palsy: aspiration vs nonaspiration. Dysphagia 1996; 11: 59-71.
26. Gisel EG, Applegate-Ferrante T, Benson JE, Bosma JF. Effect of oral sensorimotor treatment on measures of growth, eating efficiency and aspiration in the dysphagic child with cerebral palsy. Dev Med Child Neurol 1995; 37: 528-543.