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Cerebral Palsy and Dysphagia Therapy

Dysphagia is a condition associated with cerebral palsy that makes swallowing difficult and sometimes painful. Some patients may be completely unable to swallow or may have trouble swallowing liquids, foods, or saliva. Dysphagia tends to be most common with cases of severe cerebral palsy and dysphagia therapy can be affective in alleviating associated problems.

Dysphagia occurs when there is a problem with any part of the swallowing process. Weak tongue or cheek muscles make it hard to move food around in the mouth for chewing. Food pieces that are too large for swallowing may enter the throat and block the passage of air. Other problems include not being able to start the swallowing reflex, a stimulus that allows food and liquids to move safely through the pharynx. People with dysphagia are unable to begin the muscle movements that allow food to move from the mouth to the stomach. Another difficulty can occur when weak throat muscles cannot move all of the food toward the stomach. Pieces of food can fall or be pulled into the trachea, which may result in aspiration pneumonia.

Dysphagia may be caused by any condition that weakens or damages the nerves and muscles used for swallowing, especially cerebral palsy. Physicians and speech-language pathologists who test for and treat swallowing disorders use a variety of tests that allow them to look at the parts of the swallowing mechanism, including a fiber optic laryngoscope, video fluoroscopy, and ultrasound.

Once the cause of the dysphagia is found, surgery or medication may help to treat and control it. If treating the cause of the dysphagia does not help, the physician may refer the patient to a speech-language pathologist who is trained in testing and treating swallowing disorders. The speech-language pathologist will test the person's ability to eat and drink and may also teach the person new ways to swallow.

Oral-motor therapy is directed at correcting abnormal oral muscle behaviors that interfere with feeding. Oral-motor therapy may be focused upon inducing active sucking movements, coordinating tongue movements, or facilitating normal oral movement patterns such as lip closure.

Oral-motor therapy has also been used in cerebral palsy children to stop drooling, correct abnormal tongue thrust, and improve speech. Speech management of the cerebral palsy and dysphagia therapy child has included training to improve the functioning of oral and pharyngeal muscles. This oral-motor training is usually introduced before the emergence of speech.

An electrical stimulation technique has been examined for cerebral palsy and dysphagia therapy and has recently been approved by the FDA. VitalStimâ therapy uses small electrical currents to stimulate the muscles responsible for swallowing. At the same time, trained specialists help patients "re-educate" their muscles through rehabilitation therapy. During clinical trials, over 38 percent of patients with severe dysphagia regained full normal swallow function after treatment and the only side effects have been slight redness of the skin.

With 50 pairs of muscles involved in the swallowing process affected by cerebral palsy and dysphagia therapy becoming more advanced, dysphagia will become more manageable over time. Cerebral palsy can cause a child many difficulties and minimizing any symptoms can make a great impact.

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