Dysphagia in paediatric acquired brain injury: Prevalence, outcomes, and impact of lesion sites on recovery
Emma Glisson, Martin Smith, Emma Pagnamenta, George PontikasAbstract
Aim
To explore the prevalence and outcomes of dysphagia in paediatric acquired brain injury, associated with aetiology, unilateral and bilateral injury, and brain regions involved, while considering age, sex, and length of stay.
Method
This was a retrospective observational cohort study of 85 children with acquired brain injury (50 males, 35 females; age range 6 months to 16 years, mean 8 years 2 months, SD 5 years 3 months). Aetiologies included traumatic brain injury (TBI) ( n = 24), stroke/vascular injury ( n = 23), hypoxic/ischaemic injury ( n = 8), infection ( n = 15), autoimmune conditions ( n = 8), and other causes ( n = 7). Dysphagia at admission and discharge was recorded; magnetic resonance imaging review identified lesion laterality and regions involved. One‐year follow‐up evaluated recovery in children with dysphagia at discharge.
Results
Dysphagia prevalence at admission varied (TBI 83%, stroke/vascular 52%, hypoxic 100%, infection 87%, autoimmune 63%, other 43%), decreasing at discharge (TBI 33%, stroke/vascular 8%, hypoxic 87%, infection 13%, autoimmune 25%, other 0%). At admission, 97.6% of children with bilateral injury presented with dysphagia, compared to 47.7% with unilateral injury. All children with unilateral injury had resolved dysphagia at discharge, compared to 47.5% with bilateral injury. Children with both cortical and subcortical injury showed low resolution of dysphagia at discharge (33%).
Interpretation
Dysphagia is prevalent in paediatric acquired brain injury. Bilateral injuries, particularly involving cortical and subcortical regions, are associated with persistent dysphagia.