A study of the resolution of paediatric dysphagia following traumatic brain injury: practical implications for clinicians

Abstract

Despite the potentially life-threatening complications of dysphagia (Martin, Corlew, Woods, Olson and Golopol, 1994), and the recognized benefits of early and informed intervention in the acute care setting (Mackay, Bernstein, Chapman, Morgan & Milazzo, 1992), limited research exists on the acute phase or the resolution of swallowing impairment in children subsequent to traumatic brain injury (TBI) (Rowe, 1999; Ward and Morgan, in press). The current paper presents descriptive data detailing the characteristics of dysphagia in three paediatric cases following TBI subsequent to motor vehicle accident (MVA) at both initial presentation and six months post-injury. During the acute phase, patients presented with a combination of oral and pharyngeal phase deficits that were clinically determined to have resolved in all three children months prior to the six-month videofluoroscopic assessment. The follow-up modified barium swallow, however, revealed residual physiological deficits of the swallowing mechanism in all three children and continued evidence of laryngeal penetration in one case. This data provides a starting point for further investigation into the resolution of swallowing impairment present in children following TBI, and raises important issue for clinicians regarding management and follow-up assessment in this population.