Care continuity for patients with cerebral palsy during transition from childhood to adulthood

: Around adolescence and thereafter, many cases with severe cerebral palsy have worsening of respiration and swallowing due to worsening of deformity and other factors. Appropriate management including prone positioning, naso-pharyngeal air-way, and positive pressure breathing with mask and bag or in-ex sufflator is effective for chronic respiratory disorder. Modification of posture or food texture according to the result of video-fluorographic examination may be effective for dysphagia along with intermittent oral catheterization feeding. Gastro-esophageal reflux and stasis in duodenum get worse around this age. Gastro-jejunal feeding with hand-made catheter set is useful. Cervical myelopathy and radiculopathy may be critical in athetoid type of cerebral palsy. Pseudoseizure as expression of conversion disorder should be considered especially around this age.