Gastroesophageal reflux in pediatric neurologic patients
Vega Gutiérrez ML, Benito Fernández C, Alvarez Gómez MJ, Hernández Lizoáin JL, Narbona García J [SP], Villa Elizaga L.
Departamento de Pediatría, Unidad de Neurología Infantil, Clínica Universitaria, Facultad de Medicina, Universidad de Navarra, Pamplona.
Magazine: Anales Españoles de Pediatría
Date: Mar 1, 1993General and Digestive Surgery Pediatrics [SP]
With the aim of evaluating the incidence of gastroesophageal reflux (GER) in neurologic pediatric patients with severe motor and/or psychiatric involvement, a retrospective study of 140 infants followed at the Neuropediatric Unit was realized. Forty-five patients (32.1%) had moderate to severe mental retardation (ms RR), 21 of these patients had associated tetraparetic cerebral palsy (T-CP).
The rest of the infants presented variable degrees of neurologic involvement: 25 diplegic (D-CP), 27 hemiparetic (H-CP), 22 with slight mental retardation or borderline IQ without motor deficit (SMR), and 21 had attention deficit disorder with hyperactivity (ADD-H). The diagnosis of GER was based on clinical symptomatology and barium ingestion with fluoroscopy and/or esophagoscopy. GER was confirmed in 27 patients: 19 (90.5%) with T-CP, 6 (25%) with ms-MR and 2 (8%) with D-CP. The rest of the infants did not have GER. There was a very significant difference in the frequency of GER in the T-CP group with respect to the other groups (p < 0.001) and a significant difference in the ms-MR patients with respect to the other groups (p < 0.05).
The treatment of GER was surgical in ten patients (37%), after failure of medical treatment in 8; exclusively medical treatment in 10 cases (37%) and postural and dietetic treatment in 7 (26%) patients. Good control of GER, resulting in an improvement in the quality of life, occurred in 90% of the patients treated surgically and only in 55% of the patients treated medically.
CITATION An Esp Pediatr. 1993 Mar;38(3):232-6
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