ABSTRACT
Undernutrition is a frequent problem in children with cerebral palsy who often have significant impairment of the eating and swallowing mechanism. A prevalence of oropharyngeal dysfunction and gastroesophageal reflux [GER] in 30 preschool children with cerebral palsy [CP] was studied using videofluoroscopy with barium contrast. The relation of their feeding dysfunction to their nutritional status was evaluated. Seventeen of these children had spastic tetraplegia, 10 had cerebral diplegia and only 3 had hemiplegia. Five children [16.7%] of our sample had no feeding dysfunction, they all had mild functional motor impairment and topographically, they had diplegia; 83.3% of these children had feeding dysfunction. Of these, 44% had combined dysfunction, 28% had isolated swallowing defect and 28% had isolated GER. Evidence of respiratory infection was present in 7 patients during radiological examination. Malnutrition, defined as triceps skin fold thickness [TSF] less than the third percentile for age and sex, was present in 50% of the cases. We found negative correlation between the degree of severity of cerebral palsy and both TSF and weight standard deviation score [r: -0.867, r: -0.748respectively]. Children with combined swallowing defect and GER had the lowest mean TSF and weight standard deviation score [3.26 +/- 0.52 mm and -3.4 +/- 0.87 respectively]. These findings were statistically significant [F= 2.83 and 3.12 respectively]. This study showed the value of using videofluoroscopy for assessment of feeding dysfunction in children with cerebral palsy. Assessment of secondary malnutrition and feeding dysfunction should be regarded as an important part of their general care. A multidisciplinary team should carry out this assessment