Gastroesophageal Reflux in the Child with Cerebral Palsy

Gjikopulli, Arieda; Kutsch, Erika; Berman, Loren; Prestowitz, Sky

doi:10.1007/978-3-319-74558-9_52

Cited by 1 publication

(4 citation statements)

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“…Gastroesophageal reflux disease (GERD) is defined as the pathologic sequelae of retrograde gastric contents movement into the esophagus as it leads to symptoms or complications such as dysphagia, dental erosions, poor weight gain, and vomiting ( 27 , 28 ). Children with spastic quadriplegic GMFCS V cerebral palsy (CP) are at an increased risk for GERD due to a number of contributing factors such as chronic supine position (immobilization), scoliosis which may displace the stomach and stretch the lower esophageal sphincter together with a spastic body state will increase intraabdominal pressure, therefore promote GERD, delayed gastric emptying, inadequate oral intake, and abnormal autonomic control of gastrointestinal motility as it leads to an impaired clearance to refluxate ( 27 ). Although literature discussing GERD and CP is scarce, the incidence of GERD in children with CP has been reported to vary from 15% to 91% by different studies ( 28 , 29 ).…”

Section: Multisystem Consequences Of Atypical Movement Patternmentioning

confidence: 99%

“…CP spastic quadriplegic with GERD may present with feeding difficulties (refusal and/or intolerance); recurrent vomiting, nausea, heartburn, and pain in the epigastric area; the presence of dysphagia and/or odynophagia; and GERD may exacerbate and worsen respiratory diseases, either by aspirations of refluxate leading to inflammatory changes in the respiratory tract or by ineffective reflexive responses of the airway to refluxed material such as coughing, laryngospasm, and apnea ( 27 ). Oromotor dysfunction and abnormalities of pharyngeal coordination can sometimes mask or be confused with GERD ( 28 ).…”

Section: Multisystem Consequences Of Atypical Movement Patternmentioning

confidence: 99%

“…Medications used frequently in the treatment of spasticity and seizures associated with CP patients have side effects that can cause delayed gastrointestinal motility, so it is best to consider the side effects as an exacerbating factor and withdrawal symptoms (use of baclofen, opioids, benzodiazepines, tricyclic antidepressants) that may result in GERD ( 27 , 29 , 30 ).…”

Section: Multisystem Consequences Of Atypical Movement Patternmentioning

confidence: 99%

“…Besides, ensuring an upright position especially during meals can help decreasing the frequency of reflux episodes. The different treatment approaches available may have variable degrees of effectiveness in each case, but timely management can prevent serious complications from GERD ( 27 , 29 ).…”

Section: Multisystem Consequences Of Atypical Movement Patternmentioning

confidence: 99%

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Multisystem compensations and consequences in spastic quadriplegic cerebral palsy children

Wahyuni

2023

Front. Neurol.

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Spastic quadriplegic cerebral palsy (CP) is a permanent neuromuscular disorder causing limitation on all four limbs following a lesion on the developing brain. Most children with spastic quadriplegic CP are identified to be Gross Motor Function Classification System (GMFCS) level V, thus they have more comorbidities compared to other types at lower levels. Spastic quadriplegic CP is characterized by weak and inactive postural muscles of the neck and trunk, hence, they will undergo a total body extension as a compensatory mechanism leading to an atypical movement pattern, that give rise to multisystem consequences that reduce their quality of life. The relationship between atypical movement patterns, compensatory strategies, and multisystem consequences have not yet been explored. In fact, these multisystem consequences aggravate their condition and make movement much more atypical, forming a vicious cycle. This review aimed to provide a summary and highlight the mechanism of atypical movement pattern, multisystem compensations, and consequences in spastic quadriplegic CP children. It is true that central nervous system (CNS) lesion in CP is non-progressive, however the multisystem consequences may impair overall function over time. An understanding of how compensatory strategy and multisystem consequences in spastic quadriplegic CP offers the opportunity to intervene as early as possible to improve their quality of life.

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