Drooling in Children with Cerebral Palsy: A Retrospective Observational Study of Clinical Characteristics, Severity, and Treatment

Objectives: To report the characteristics, severity, and treatment of drooling in cerebral palsy (CP) children.Methods: This retrospective observational study included CP children with active complaints of drooling from the Drooling Clinic, Sultan Bin Abdulaziz Humanitarian City (Riyadh, Saudi Arabia). Drooling severity was assessed via the Modified Drooling Questionnaire (MDQ). The functional motor and manual ability levels were classified via the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS).Results: In total, 122 patients were identified. Mean age was 6.28 ± 2.71 years, and 67/122 (54.9%) were boys. Gastroesophageal reflux disease was noted in 23/122 (18.9%). Drooling was anterior for most (n = 103/120, 85.8%), 82/85 (96.5%) had spastic CP, and 49/82 (59.8%) had quadriplegia. Level III (n = 36/110, 32.7%) on GMFCS and level V (n = 53/110, 48.2%) on MACS were the most common. Bilateral involvement was present in 106/110 (96.4%). For drooling severity assessed via the MDQ (mean = 17.00 ± 4.03; range = 11–34), majority experienced mild (n = 109/122, 89.3%) or moderate (n = 12/122, 9.8%) drooling. Overall, 36/122 (29.5%) patients received pharmacological treatment, among whom glycopyrrolate and scopolamine patches were the most frequently used, each of which was administered to a similar proportion of patients (n = 21/36, 58.3%).Conclusion: Drooling remains a common problem in CP children, particularly those with greater motor and manual impairment (GMFCS III, MACS V). It is most often anterior with mild-to-moderate severity, although one patient presented with severe drooling.