ANORECTAL FUNCTION OF CHILDREN WITH NEUROLOGICAL PROBLEMS .2. CEREBRAL-PALSY

In response to the frequent complaint of difficulties with defecation experienced by children with cerebral palsy, 34 children (13 girls and 21 boys, mean age 10 years) with cerebral palsy were investigated by questionnaire and anorectal manometry. 24 enuretic children served as controls for the anorectal manometry. Constipation affected 26 of 29, defecation distress eight and faecal incontinence 16 of the index chil dren, but incontinence was mild in most cases. Index children had a lo w resting pressure in the first centimetre of the anal canal, slow ana l rhythmical activity and a pressure increase in the first centimetre during maximum rectal distension. These findings suggest anal sphincte r and/or pelvic floor muscle inco-ordination, but no evidence of abnor mal rectal function. The authors conclude that surgical intervention w as not indicated for the index children, but that medical treatment co uld be improved.