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Videofluoroscopic assessment in children with severe cerebral palsy presenting with dysphagia
R E Wright1, F R Wright, C A Carson
1Ulster Hospital Dundonald, Beltast, UK.
Insights
Videofluoroscopy aids in diagnosing feeding issues in children with severe spastic cerebral palsy. Early diagnosis helps manage silent aspiration and prevent malnutrition.
Area of Science:
- Pediatric Gastroenterology
- Neurology
- Speech-Language Pathology
Background:
- Severe spastic cerebral palsy often presents with significant feeding difficulties.
- Inefficient eating and aspiration are common complications impacting nutritional status.
Purpose of the Study:
- To evaluate the utility of videofluoroscopy in assessing swallowing function in children with severe spastic cerebral palsy.
- To identify correlations between oral phase deficits and aspiration.
Main Methods:
- Videofluoroscopic swallowing study (VFSS) and modified barium swallow were performed on 16 pediatric patients.
- Patients ranged from 6 months to 16 years with severe spastic cerebral palsy.
Main Results:
- All patients exhibited slow and inefficient eating patterns.
- Silent aspiration was identified in 5 patients, all with delayed swallow reflex.
- Little correlation was found between aspiration and the oral phase of deglutition.
Conclusions:
- Videofluoroscopy is a valuable tool for early diagnosis and management of feeding problems in pediatric cerebral palsy.
- Timely intervention can prevent chronic aspiration, malnutrition, and associated complications.
Abstract:
In this study 16 patients with severe spastic cerebral palsy with an age range between 6 months and 16 years were examined using videofluoroscopy and a modified barium meal. All patients were slow, inefficient eaters. Silent aspiration was demonstrated in five cases. The latter five patients demonstrated a delayed swallow reflex but there was little correlation between aspiration and the oral phase of deglutition. Our data confirms the impression that early diagnostic workup including videofluoroscopy is helpful in managing the feeding difficulties in these children, and may prevent chronic aspiration and malnutrition.