Abstract | Keywords | Export | Availability | Bookmark

Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

ABSTRACT Objective : This scoping review aims to identify the available scientific evidence for infantile swallowing disorders in neurological diseases such as Intracranial Haemorrhage (ICH), Arterial Ischemic Stroke (AIS) and Hypoxic Ischemic Encephalopathy (HIE). The following aspects of swallowing disorders will be investigated: the (a) prevalence, (b) types of swallowing/feeding issues, (c) diagnostic tools, (d) available treatment options and (e) the involvement of the multidisciplinary healthcare team. Methods : The study design presumed upon the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A structured search strategy was conducted in five databases and one register system, pertaining to three concepts : swallowing/feeding disorders, infants and neurological disorders. Results : The search strategy yield an aggregate of 5,110 articles and 25 out of them met the inclusion criteria. The available evidence about swallowing disorders was analysed in three main categories according to the occurring disease in infants: 1. Intracranial Haemorrhage (ICH), 2. Arterial Ischemic Stroke (AIS) and 3. Hypoxic Ischemic Encephalopathy (HIE). The prevalence of swallowing disorders in ICH and AIS is documented in the majority of the relevant articles included but it is rarely discussed in HIE. The most common clinical presentations in neonates or infants are vomiting and poor sucking in ICH, aspiration/high risk for aspiration and gastroesophageal reflux in AIS. Aspiration, sucking/breastfeeding difficulties and persistent feeding impairment are mostly presented in HIE. Limited data are found for ICH and the diagnostic evaluation of swallowing problems. However, instrumental evaluation is often utilized. The literature does not identify any available means of assessment in AIS. When investigating deglutitive impairment in HIE population, both clinical and instrumental means are indicated; VFSS, pharyngo-esophageal and/or esophageal manometry and the Penetration Aspiration Scale (PAS) are most often employed. Alternative feeding methods such as nasogastric/gastrostomy tube are the predominant means of dysphagia management. Diet modification is also reported in AIS intervention plans. Oral stimulation is frequently mentioned in HIE treatment options. Overall, paediatric neurologists and Speech and Language Pathologists (SLPs) are reported to be the prevailing healthcare professionals in the multidisciplinary team recruitment. The complicity of the multidisciplinary healthcare team is not extensively identified in the literature. Conclusion : This scoping review indicates that deglutitive issues are present in the neonatal neurological diseases. There is only limited data available on swallowing issues in ICH and AIS population. In the case of HIE, there is limited evidence for the manifestations, the assessment and the intervention methods. The contribution of the multidisciplinary healthcare team to dysphagia management is lacking in literature. These research findings underline the importance of further investigation to analyse the nature of feeding problems, enrich dysphagia toolkit and identify the best ways for dysphagia management in infants with neurological impairment. Keywords : Swallowing, Feeding, Deglutition, Dysphagia, Infants, Intracranial Hemorrhage, ICH, Arterial Ischemic Stroke, AIS, Hypoxic Ischemic Encephalopathy, HIE