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Journal of the Korean Academy of Rehabilitation Medicine 1998;22(3):506-515.
Characteristics of Swallowing Disorder in Pediatric Patients with Central Nervous System Disorders: Comparing to Central Nervous System Intact Patients with Gastro-intestinal Disorders.
Kim, Hyeon Sook , Choe, June Jungyun
1Department of Physical Medicine and Rehabilitation, Sung Kyun Kwan University College of Medicine.
2Department of Physical Medicine and Rehabilitation, Samsung Medical Center.
중추 신경계 손상 소아의 연하 곤란의 특징 정상 중추신경계 기능을 가진 소화기계 이상 소아와의 비교를 중심으로
김현숙, 최정윤1
성균관대학교 의과대학 재활의학교실 및 1삼성서울병원 재활의학과
Abstract

Objective
To evaluate common symptoms and severities of swallowing disorders in pediatric patients with a central nervous system disorder.


Method
Twenty six pediatric patients with age ranging from 1 month to 3 years who had complained feeding and swallowing difficulties were studied. The subjects were divided into two groups according to the presence or absence of a central nervous system disorder. After taking the history and physical examination, a bedside swallowing test and a videofluoroscopic swallowing study were done. The parameters of oral preparatory phase, oral phase and pharyngeal phase were evaluated.


Results
In the bedside swallowing test, the patients with a central nervous system disorder showed a significantly higher incidence of decreased swallowing reflex, postural abnormality, tendency of poor secretion control and absent gag reflex. In the videofluoroscopic swallowing study, patients with a central nervous system disorder showed delayed oral transport time, poor oral control, pharyngeal triggering, aspiration, nasal regurgitation and esophageal reflux. Compared to the patients without a central nervous system disorder, the patients with a central nervous system disorder showed a significantly higher incidence of decreased pharyngeal peristalsis and delayed pharyngeal triggering. The patients with a central nervous system disorder also showed a more profound swallowing disorder than that of the patients without a central nervous system disorder, having more chances of a non-oral feeding than those without a central nervous system disorder.


Conclusion
The children with a swallowing disorder and central nervous system disorder showed the different features from those without a central nervous system disorder in the bedside swallowing test and videofluoroscopic swallowing study. So that a complete swallowing evaluation including the videofluoroscopic a swallowing study will be helpful to children with swallowing disorder and central nervous system disorder for the evaluation and treatment of pharyngeal stage swallowing dysfunction.

Key Words: Pediatric swallowing disorders, Bedside swallowing examination, Videofluoroscopic swallowing study(VSS), Central nervous system disorder


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