Drooling in oro-motor dyspraxia: is there a role for surgery?

2009 ◽  
Vol 123 (8) ◽  
pp. 931-933 ◽  
Author(s):  
J Rimmer ◽  
B E J Hartley
Keyword(s):  
Cerebral Palsy ◽  
Case Report ◽  
Surgical Approach ◽  
Neurological Disorders ◽  
Surgical Techniques ◽  
Definitive Treatment ◽  
Language Therapy ◽  
Speech And Language Therapy ◽  
Submandibular Duct ◽  
Children With Cerebral Palsy

AbstractObjective:To report the successful use of a surgical approach for the treatment of drooling in a case of oro-motor dyspraxia.Case report:A seven-year-old girl with a diagnosis of oro-motor dyspraxia was referred for management of drooling; this was her only symptom. There were no focal neurological abnormalities. Conservative measures had not helped, and her parents were keen for definitive treatment. Bilateral submandibular duct transposition was performed with no complications. The patient's drooling improved immediately.Conclusion:There are currently no reports in the literature of surgery for persistent drooling in children with oro-motor dyspraxia who are otherwise neurologically and developmentally normal. The mainstay of treatment is speech and language therapy. We report the successful use of surgical techniques, usually reserved for children with cerebral palsy or severe neurological disorders, to treat drooling in an otherwise normal seven-year-old child with oro-motor dyspraxia.

scholarly journals Clinical Relevance of State-of-the-Art Analysis of Surface Electromyography in Cerebral Palsy

2020 ◽  
Vol 11 ◽  
Author(s):  
Germana Cappellini ◽  
Francesca Sylos-Labini ◽  
Carla Assenza ◽  
Laura Libernini ◽  
Daniela Morelli ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Neurological Disorders ◽  
Surface Electromyography ◽  
Clinical Relevance ◽  
State Of The Art ◽  
Neuromuscular System ◽  
Neural Controllers ◽  
Children With Cerebral Palsy ◽  
Tendon Surgery ◽  
Reference Databases

Surface electromyography (sEMG) can be used to assess the integrity of the neuromuscular system and its impairment in neurological disorders. Here we will consider several issues related to the current clinical applications, difficulties and limited usage of sEMG for the assessment and rehabilitation of children with cerebral palsy. The uniqueness of this methodology is that it can determine hyperactivity or inactivity of selected muscles, which cannot be assessed by other methods. In addition, it can assist for intervention or muscle/tendon surgery acts, and it can evaluate integrated functioning of the nervous system based on multi-muscle sEMG recordings and assess motor pool activation. The latter aspect is especially important for understanding impairments of the mechanisms of neural controllers rather than malfunction of individual muscles. Although sEMG study is an important tool in both clinical research and neurorehabilitation, the results of a survey on the clinical relevance of sEMG in a typical department of pediatric rehabilitation highlighted its limited clinical usage. We believe that this is due to limited knowledge of the sEMG and its neuromuscular underpinnings by many physiotherapists, as a result of lack of emphasis on this important methodology in the courses taught in physical therapy schools. The lack of reference databases or benchmarking software for sEMG analysis may also contribute to the limited clinical usage. Despite the existence of educational and technical barriers to a widespread use of, sEMG does provide important tools for planning and assessment of rehabilitation treatments for children with cerebral palsy.

scholarly journals Internet delivery of intensive speech and language therapy for children with cerebral palsy: a pilot randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e024233 ◽  
Author(s):  
Lindsay Pennington ◽  
Elaine Stamp ◽  
Johanna Smith ◽  
Helen Kelly ◽  
Naomi Parker ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Randomised Controlled Trial ◽  
Outcome Measures ◽  
Controlled Trial ◽  
Language Therapy ◽  
Treatment As Usual ◽  
Pilot Randomised Controlled Trial ◽  
Speech And Language Therapy ◽  
Randomised Controlled ◽  
Internet Delivery

ObjectivesTo test the feasibility of recruitment, retention, outcome measures and internet delivery of dysarthria therapy for young people with cerebral palsy in a randomised controlled trial.DesignMixed methods. Single blind pilot randomised controlled trial, with control offered Skype therapy at end of study. Qualitative study of the acceptability of therapy delivery via Skype.SettingNine speech and language therapy departments in northern England recruited participants to the study. Skype therapy was provided in a university setting.ParticipantsTwenty-two children (14 M, 8 F) with dysarthria and cerebral palsy (mean age 8.8 years (SD 3.2)) agreed to take part. Participants were randomised to dysarthria therapy via Skype (n=11) or treatment as usual (n=11).InterventionsChildren received either usual speech therapy from their local therapist for 6 weeks or dysarthria therapy via Skype from a research therapist. Usual therapy sessions varied in frequency, duration and content. Skype dysarthria therapy focused on breath control and phonation to produce clear speech at a steady rate, and comprised three 40 min sessions per week for 6 weeks.Primary and secondary outcome measuresFeasibility and acceptability of the trial design, intervention and outcome measures.ResultsDepartments recruited two to three participants. All participants agreed to random allocation. None withdrew from the study. Recordings of children’s speech were made at all time points and rated by listeners. Families allocated to Skype dysarthria therapy judged internet delivery of the therapy to be acceptable. All families reported that the study design was acceptable. Treatment integrity checks suggested that the phrases practised in one therapy exercise should be reduced in length.ConclusionsA delayed treatment design, in which dysarthria therapy is offered at the end of the study to families allocated to treatment as usual, is acceptable. A randomised controlled trial of internet delivered dysarthria therapy is feasible.

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