Dysphagia in cerebral palsy

Feeding problems are often present in children with neuromotor impairment: dysphagia is usually seen in the most severe form of cerebral palsy and it’s defined as the difficulty with any of the four phases of swallowing. Clinical consequences are malnutrition and recurrent chest infections that reduce expected duration and quality of life. In order to prevent these consequences it’s important to detect with clinical and instrumental examinations dysphagia symptoms and to treat them. Clinical evaluation focuses mainly on the oral stage of dysphagia i.e. patterns of oral dysfunction but is not able to assess accurately the pharyngeal and esophageal phases that can be studied with instrumental evaluation like videofluoroscopy. Videofluoroscopy data provide the basis for an objective planning of the treatment only if combined with careful clinical examination. Treatment options include rehabilitative measures such as postural management and food texture modification and in the most severe cases surgical procedures.