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Query: UMLS:C0011168 (
dysphagia
)
15,644
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Dysphagia
is a common finding in infants and children with neuromuscular disabilities.
Dysphagia
may be developmental, as in the preterm infant, transient, chronic, or progressive. The evaluation of
dysphagia
must take into account the age of the patient and typical development of feeding and swallowing for that age. The typical abilities seen in neonatal, early infancy, later infancy and early childhood periods vary in sensorimotor skills and feeding efficiency. In addition to knowing the substrate of expected skills by age, knowledge of the neurophysiology of feeding and swallowing is essential to diagnosis. Each physiologic phase of deglutition: oral, pharyngeal, and esophageal can present with symptoms of
dysphagia
that can guide investigation. Common symptoms of
dysphagia
include generalized feeding difficulty such as poor efficiency, food refusal and failure to thrive. Specific symptoms include tongue thrust, choking, cough, and oxygen desaturation. The possibility of
dysphagia
can be identified through a thorough feeding history. Examination initially includes the infant's muscle tone and posture in the head, neck and body. Anomalies of structures of the head and neck must be identified and examined for their effect on function. Next, examination of oral structures for reflexes, tongue movements, and symmetry will identify neurologic abnormalities. Observation of feeding is essential and will reveal signs of
dysphagia
. Aspiration in the infant can present without specific signs.
Respiratory abnormalities
or Gastroesophageal reflux can be identified during history or examination. Investigation of
dysphagia
most commonly includes videofluoroscopy, endoscopy, and ultrasonography. The management of
dysphagia
requires an individualized approach and will include neurologic, respiratory, nutritional and possibly gastrointestinal management. Six broad areas are identified that must be considered in the management of
dysphagia
in infants and children. They include: normalization of posture and positioning, adaptation of foods and feeding equipment, oromotor therapy, feeding therapy, nutritional support and management of associated disorders. A team of professionals will assist the parent and child in achieving pleasant feedings to foster appropriate growth and development.
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PMID:Investigation and management of dysphagia. 1499 57
