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Children with cerebral palsy (CP)

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Cerebral Palsy (CP) is one of the most common chronic physical disorders that affect the motor function in children. Common features of these children are, besides poor motor control, epilepsy, feeding problems, hearing, vision and intellectual impairment as well as autism and psychosocial behavioral problems. The condition is very heterogeneous and can range from a mild to a very severe disability. Cerebral palsy is divided into different subtypes according to the clinical affection of the motor disturbances such as CP-diplegia, affecting mainly both legs and CP-hemiplegia affecting one side of the body. Patients in the dyskinetic and the tetraplegic subtypes are the most disabled patients. They have big problems in controlling their movements. These disabilities is partly due to spasticity in the muscles. There is also one ataxic subtype with mainly balances disturbances.

Besides the difficulties of controlling the muscles of the arms and legs these children also have difficulties in controlling the oral muscles. This can lead to problems with chewing and swallowing food. Sometimes the food goes in a wrong direction into the lungs; they aspirate. That could lead to breathing problems and infections. To eat is a great effort for the most disabled child and it also takes a long time and requires energy. Therefore underweight is a common feature in children with CP. The underweight is also believed to partly result from the higher energy demand of eating and also by the associated muscle spasticity. The movement of the gut is also affected. The poor growth in patients with CP is multifactorial and there still remain many unsolved questions.

Feeding problems and gastrointestinal problems are often seen in CP-patients and especially in the dyskinetic and tetraplegic subtypes of CP. Gastroesofagal reflux disease (GERD) and motility disorder of the gut are often seen, for which they need medical treatments. But the GI-symptoms are often difficult to interpret. We need more knowledge about the gastrointestinal dysfunction in this group of patients for optimal medical treatment in order to gain weight and to avoid pain and discomfort. The main goal of the research of this group of children is to increase the knowledge of the consequences of underweight and the gastrointestinal dysfunction with emphasis on the gut-brain axis in order to find treatment that would improve health and life quality.

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