Drooling in cerebral palsy: hypersalivation or dysfunctional oral motor control?
OBJECTIVE
To investigate whether drooling in children with cerebral palsy (CP) in general and in CP subtypes is due to hypersalivation.


METHODS
Saliva was collected from 61 healthy children (30 males, mean age 9y 5mo [SD 11mo]; 31 females, mean age 9y 6mo [1y 2mo]) and 100 children with CP who drooled (57 males, mean age 9y 5mo [3y 11mo], range 3-19y; 43 females, mean age 10y 1mo [4y 9mo], range 4-19y), of whom 53 had spastic, 42 had dyskinetic, and five had ataxic CP. Almost all children were affected bilaterally, and 90 of them were at Gross Motor Function Classification System levels III or higher. The saliva was collected by the swab saliva collection method. The intensity of drooling was evaluated using the drooling quotient.


RESULTS
No difference was found in the flow rates, age, or sex between healthy children and children with CP who drooled. On additional subgroup analysis, the flow rates of children with dyskinetic CP differed statistically from those of healthy children (submandibular p=0.047, parotid p=0.040).


CONCLUSIONS
This study supports the finding in previous studies that no hypersalivation exists in children with CP who drool. Dysfunctional oral motor control seems to be responsible for saliva overflow from the mouth, whereas increased unstimulated salivary flow may occur in children with dyskinetic CP as a result of hyperkinetic oral movements.
Erasmus
Corrie E
CE
Nijmegen Multidisciplinary Drooling Centre, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. c.erasmus@cukz.umcn.nl
Van Hulst
Karen
K
Rotteveel
Liselotte J C
LJ
Jongerius
Peter H
PH
Van Den Hoogen
Frank J A
FJ
Roeleveld
Nel
N
Rotteveel
Jan J
JJ
D000293:Adolescent; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000150:complications* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009069:Movement Disorders / Q000150:complications* / Q000503:physiopathology; D010306:Parotid Gland / Q000378:metabolism; D012463:Saliva / Q000378:metabolism; D012798:Sialorrhea / Q000150:complications* / Q000209:etiology* / Q000503:physiopathology; D013363:Submandibular Gland / Q000378:metabolism; D055815:Young Adult