Viral, bacterial and aspiration pneumonias are more common in children with
CP than in other children. Oral-motor problems and GERD predispose to aspiration,
while absent or impaired gag reflexes and cough prevent other children from
effectively clearing their airways. Nurses working with this population can
teach parents to seek medical attention right away for significant respiratory
infections. Some children with CP have tracheostomy tubes, while others use
ventilators. By periodically assessing the caregivers' skills in tracheostomy
suctioning and ventilator care, nurses may be able to identify areas of risk.
Dental problems: Oral-motor problems combined with muscle spasticity of the arms and hands often make oral hygiene a significant challenge for the patient and caregivers. Nurses working with CP patients and caregivers need to be extremely diligent in teaching and reinforcing good oral hygiene techniques.
Several factors are important to the dental health of cerebral palsy patients:
Depending on the degree of muscle spasticity and the part(s) of the body involved,
health care providers may offer various medical and/or surgical treatments.
Benzodiazepines, such as diazepam, may be used for body-wide muscle relaxation.
Baclofen, which blocks impulses from the spinal cord to the muscles, can be
delivered either orally or by an implanted pump. Dantrolene, a drug that interferes
with muscle contractions, is also used to relieve spasticity and afford more
control of the voluntary muscles. Surgeons may lengthen too-short muscles and
tendons to release a contracture and enhance joint use. In some cases, a child
with CP may need a selective dorsal root rhizotomy, which reduces spasticity
in the legs by reducing the nerve stimulation to the leg muscles. Nurses caring
for children with medical or surgical treatments will tailor their interventions
to meet the specific needs of the child, taking into account the nature of the
The American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) web site has extensive resources.