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Awake upper airway obstruction in children with spastic quadriplegic cerebral palsy

Dominic J Wilkinson1, Gordon Baikie, Robert G Berkowitz

  • 1Department of Child Development and Rehabilitation, Royal Children's Hospital, Murdoch Childrens Research Institute, University of Melbourne, Melbourne, Victoria, Australia.

Journal of Paediatrics and Child Health
|February 21, 2006
PubMed

Insights

Severe cerebral palsy can cause awake upper airway obstruction (UAO) in children, often due to pharyngeal collapse. This serious complication requires intensive care and can lead to prolonged hospitalization.

Area of Science:

  • Pediatric Pulmonology
  • Neurology
  • Critical Care Medicine

Background:

  • Severe cerebral palsy (CP) is associated with various complications.
  • Upper airway obstruction (UAO) during wakefulness is an under-recognized issue in children with severe CP.

Observation:

  • This case series investigated awake UAO in children with severe CP.
  • Eight children with severe CP admitted for UAO were analyzed.
  • One detailed case presentation is included.

Findings:

  • Seven of eight children required intensive care; one child died.
  • Pharyngeal collapse, not anatomical obstruction, was the primary cause in most cases.
  • One child had an underlying brainstem malignancy.

Implications:

  • Awake UAO is a life-threatening complication in severe CP.
  • Pharyngeal hypotonia and collapse contribute significantly to UAO.
  • Management can be complex, necessitating prolonged hospitalization and intensive care.
Abstract

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