A Pragmatic Approach to Assessment of Chronic and Recurrent Pain in Children with Severe Neurologic Impairment
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Published on: July 4, 2018
Simone Benvenuto1, Andrea Trombetta1, Egidio Barbi2
1Department of Medical, Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy.
Insights
Pain management in children with severe neurologic impairment (SNI) is challenging due to communication difficulties. This article discusses fundamental principles for recognizing and addressing pain in these complex pediatric patients.
Area of Science:
- Pediatric Neurology
- Pain Management
- Neurodevelopmental Disorders
Background:
- Severe neurologic impairment (SNI) encompasses central nervous system disorders originating in childhood.
- SNI often leads to motor and cognitive impairments, requiring significant daily living assistance.
- Children with SNI may struggle to self-report pain or display atypical pain behaviors.
Purpose of the Study:
- To outline essential principles for approaching pain assessment and management in children with SNI.
- To improve recognition of pain in non-verbal or behaviorally atypical pediatric populations.
- To provide guidance for healthcare professionals caring for children with complex medical needs.
Main Methods:
- Discussion of basic principles for pain management in pediatric SNI.
- Review of challenges in pain recognition for non-communicative patients.
- Exploration of atypical pain manifestations in children with central nervous system disorders.
Main Results:
- Pain in children with SNI can be easily missed due to communication barriers.
- Uncommon behaviors may be the only indicators of pain.
- A systematic approach is crucial for effective pain management.
Conclusions:
- Recognizing and managing pain in children with SNI requires specialized knowledge and careful observation.
- Understanding atypical pain presentations is vital for accurate assessment.
- Implementing structured pain management strategies can improve patient outcomes.
Abstract:
The term "severe neurologic impairment" (SNI) is used to describe a group of disorders of the central nervous system which arise in childhood, resulting in motor impairment, cognitive impairment and medical complexity. As a result, much assistance is required with activities of daily living. Since these patients are often unable to self-report pain, or they may exhibit uncommon behaviors when suffering, pain manifestations may go unrecognized. In this article, the basic principles of how to approach pain in children with SNI are discussed.
