Drooling in cerebral palsy and its relationship with dysphagia and gross motor functioning

Objective To analyze the incidence and severity of drooling in children with cerebral palsy and explore its correlation with oral dyskinesia, dysphagia and gross motor function. Methods A hundred children with cerebral palsy treated in Qingdao Women′s and Children′s Hospital between July 2013 and 2016 and 50 healthy children examined in the health examination center were assessed using the drooling severity scale, oral motor assessment, a dysphagia disorders survey (DDS) and the gross motor function classification system (GMFCS). The relationship between drooling severity, oral dyskinesia, dysphagia and their gross motor function was analyzed. Results Of the 100 children with cerebral palsy, 32% displayed drooling (at levels II through V), which was significantly higher than among the healthy controls. Another sixty-eight displayed level I drooling. The severity of drooling was significantly different among children with different cerebral palsies. The drooling of children with spastic quadriplegia, dyskinesia or mixed-type cerebral palsy was the most severe, followed by those with ataxia and spastic diplegia whose drooling was often mild. No hemiplegic child drooled at level II. Drooling severity was negatively correlated with the oral motor score, but positively correlated with the average DDS and GMFCS scores. Conclusions About one third of cerebral palsy children suffer from drooling. Their drooling severity is closely associated with the type of the cerebral palsy, oral dyskinesia, dysphagia and GMFCS levels. Key words: Cerebral palsy; Drooling; Gross motor function classification; Dysphagia; Oral motor dysfunction