MANAGEMENT OF DROOLING IN CHILDREN WITH CEREBRAL PALSY WITH AYURVEDIC TREATMENT MODALITIES – A CASE REPORT
Abstract
Drooling occurs in about one third of children with cerebral palsy. It has been estimated that 25 to 35% of children with cerebral palsy drool to varying degrees. It is usually due to impaired swallowing because of uncoordinated tongue movements, high tonus and spastic contraction of the pharyngoesophageal sphincter, dyscoordination between the pharynx and sphincter, and a lack of coordinated control of head and neck musculature. It causes significant social handicaps and impairment in QOL of children. This can be distressing for children and their parents and caretakers. The consequences of drooling include risk of social rejection, damp and soiled clothing, unpleasant odour, irritated chapped skin, mouth infections, interference with speech and the risk of social isolation. Successful management of drooling can alleviate the associated hygienic problems, improve appearance, enhance self-esteem, and significantly reduce the nursing care time. Non-invasive methods like oral motor physiotherapy, behavioural therapy has been advocated for many decades, but results are inconsistent and time consuming. Modern medications like anti-cholinergics do not help much as they have their own side-effects. Use of other conventional methods like Botulinum toxin injections and surgical corrections are limited as they are invasive and have many aftereffects. Hence it is the need of time to bring forward treatment options with no or least side effects. Here an effort is made to reduce drooling by Ayurvedic procedures like greevapichu, pratisarana and siro abhyanga. The ranking of drooling was evaluated using the Drooling Rating Scale which revealed significant changes in severity and frequency of drooling after treatment.
Key words: Drooling, cerebral palsy, Greevapichu, Pratisarana, Siro abhyanga, Drooling Rating Scale
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