Awake upper airway obstruction in children with spastic quadriplegic cerebral palsy

Dominic J. Wilkinson, Gordon Baikie, Robert G. Berkowitz, Dinah S. Reddihough*

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    32 Citations (Scopus)


    Objective: Some children with severe cerebral palsy develop symptoms of upper airway obstruction (UAO) while awake. The aetiology, natural history and treatment of this complication have not previously been systematically described. This study documents a case series of children with severe cerebral palsy admitted to hospital because of severe awake UAO and reviews the relevant literature. Methods: The case records of children admitted to hospital with UAO while awake over an 8-month period were reviewed. Details of antecedent illness, comorbidities, acute management and follow up were collated. One case is presented in detail. Results: Eight children were admitted with UAO. Seven children required intensive care admission. One child died, and two underwent tracheostomy. Nasendoscopy showed pharyngeal collapse without anatomical obstruction in the majority. One child was discovered to have a brainstem malignancy. Conclusions: Upper airway obstruction is a potentially severe and life-threatening complication of cerebral palsy. In this series, a majority of children had obstruction related to pharyngeal hypotonia and collapse. This can lead to prolonged hospitalization and intensive care admission. It may raise difficult management issues.

    Original languageEnglish
    Pages (from-to)44-48
    Number of pages5
    JournalJournal of Paediatrics and Child Health
    Issue number1-2
    Publication statusPublished - Jan 2006


    • Airway obstruction
    • Cerebral palsy
    • Child
    • Obstructive sleep apnoea
    • Tracheostomy


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