ABSTRACT
We reviewed the neurological findings in 36 adults with history of perinatal brain injury that required gastrostomy due to progressive swallowing difficulties in a population of 624 institutionalized patients. A stereotypic pattern of progression of deficits was observed. Risk factors that correlated with increased risk of swallowing disorders included: presence of multiple handicaps; progressive deformities of the spine and extremities; decreased range of motion of mandible, laterognathism and other mandibular asymmetries. These findings suggest that spinal deformities and swallowing difficulties are part of a spectrum of impaired function of paired axial muscles in this population. The identification of these risk factors may help in the long-term care plan of severely impaired patients whose survival is extended by the use of feeding tubes.