Article

The aim of the study was to assess, retrospectively, the utility of
genioglossus electromyography (gEMG) in evaluating children with suspected
neurogenic feeding and swallowing difficulties.
METHOD: Children who were
evaluated using gEMG at a tertiary paediatric neurology dysphagia service were
reviewed. Data were analysed by the presence/absence of neurogenic changes on
gEMG and the method of feeding at their most recent follow-up. RESULTS: The study
group comprised 59 individuals (36 males, 23 females; median age 20 mo; range 1
mo-15 y). The study cohort included individuals with heterogeneous neurological
phenotypes (n=40), craniofacial syndrome (n=10), and congenital bulbar palsy
(n=9). gEMG identified 35 out of 59 (60%) with neurogenic changes. At follow-up,
24 individuals were on oral feeds and 35 were on alternative methods of feeding
(nasogastric /gastrostomy). Eight out of 24 children on oral feeds showed
neurogenic changes compared with 27 out of 35 on alternative feeds. chi(2)
analysis of feeding method at follow-up and the presence or absence of neurogenic
change on EMG was highly significant (p</=0.002). When confounding factors for
alternative feeds were accounted for on univariate analysis, the neurogenic
changes, severe gastro-oesophageal reflux disease, and respiratory comorbidities
were statistically significant in predicting the alternative feeding, whereas
growth failure and behavioural difficulties were not significant confounders.
Moreover, multiple logistic regression analysis revealed that the neurogenic
changes were independently predictive of an alternative method of feeding after
adjusting for other confounders with an odds ratio of 29.6 (95% confidence
interval 3.97-220 ; p<0.007). CONCLUSION : gEMG is a valuable complementary tool in
the evaluation of children with neurogenic dysphagia as the degree of severity is
independently correlated with long-term feeding outcomes.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith
Press.

Langue : ANGLAIS