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Year: 2013  Vol. 17   Num. Suppl. 1  - Print:
Luciana de Oliveira, Carla Andrea C. Tanuri Caldas, Liciane Pinelli Valareli, Roberto Oliveira Dantas, Weslania Viviane do Nascimento

OBJECTIVE: To report that non-adherence to speech therapy due to dysphagia in a cerebral palsy patient may have resulted in recurrent pneumonia. CASE REPORT: This report describes a male preterm neonate born at 29 weeks of gestation with an Apgar score of 4/9 and a birth weight of 1570 g, 5 years. Hypoxia was observed during cesarean delivery and tube feeding was performed in the maternity ward soon after birth. The diagnosis was tetra paretic cerebral palsy. The child had been monitored by a speech-language pathology (SLP) team from birth, and the ingestion of liquids by mouth was contraindicated; however, the family was resistant to following the recommendations of the SLP team. The patient underwent video fluoroscopy in 2009, which showed that the coordination between the swallowing phases and laryngotracheal penetration and aspiration with liquid was unsystematic. Although the patient maintained SLP therapy twice a week, he had 6 episodes of pneumonia in 2 years due to non-adherence to the instruction that was provided regarding alimentary consistency. The patient underwent a new video fluoroscopy in 2013, which showed a lack of coordination between the oral and pharyngeal phases, with penetration and silent aspiration with liquid. Despite this objective evidence of aspiration of liquids, the parents continue to offer the child oral liquids. CONCLUSION: Although the patient received proper guidance and monitoring, the lack of agreement among his family regarding the use of these guidelines became a limiting factor. This created a risk to the patient's health and worsened his quality of life, as evidenced by repeated episodes of pneumonia.



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