The management of dysphagia in children with severe damage of central nervous system

Introduction: Neurological problems concerns 70-80% of patients in pediatric home hospices. Dysphagia is the most common clinical problem in this group of children. The aim of the study is a retrospective review of the management of dysphagia in children with severe damage of central nervous system treated in Home Hospice for Children of Lodz Region.
Material and methods: Our site conducted retrospective reviews of medical records to obtain data about all patients treated in Home Hospice for Children of Lodz Region in the period from 2005 to 2009. Data obtained from the review of medical records were as follows: sex, birth date, formal primary diagnosis, presence of dysphagia symptoms, management and adverse events.
Results: Medical records of 107 patients were analysed. Sixty one (57%) patients needed enteral nutrition: 26 (24%) patients were feeded by nosogastral tube (25 patients) or nosojejunal tube (1 patient), 35 (33%) patients were feeded by percutaneous endoscopic gastrostomy/percutaneous endoscopic jejunostomy.
Conclusions: Dysphagia is the most common clinical problem concerning children with severe damage of central nervous system and atypical clinical symptoms should be the reason of necessity for especially careful analysis. Enteral nutrition using PEG is management of choice in this group of patient, being cheep and safe method of treatment. Knowledge and experience of hospice team, careful review of patient’s medical history, choice of adequate diagnostic methods and appropriate management causes improvement and stabilisation of health and neurological state of patient with severe damage of central nervous system and improves their quality of life.