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Timeline of diagnosed pain causes in children with severe neurological impairment
Francesca Peri1,2, Elena Magni3, Filippo Pigani1
1Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.
Insights
Diagnosing pain in children with severe neurological impairment is challenging. This study found specific pain causes are more common at different ages, aiding diagnosis.
Area of Science:
- Pediatric Neurology
- Pain Management
- Developmental Disabilities
Background:
- Diagnosing pain in children with severe cognitive impairment presents unique challenges.
- Understanding age-specific pain patterns is crucial for effective clinical management.
Purpose of the Study:
- To investigate the relationship between the causes of pain and the age of children with severe neurological impairment.
- To identify age-related patterns in pain etiology for improved diagnostic approaches.
Main Methods:
- A multicenter retrospective study involving 80 children (1-18 years) with severe neurological impairment.
- Pain causes and procedures were collected and categorized into age groups: infants/toddlers, preschool, schoolchildren, and adolescents.
Main Results:
- Gastroenterological pain was prevalent in younger children (0-5 years).
- Orthopaedic and dental pain were more common in schoolchildren and adolescents.
- Surgical procedures like PEG placement and fundoplication were frequent in early childhood, while cardiac surgery was noted in infants and orthopaedic surgery in older children.
Conclusions:
- Pain causes in children with severe neurological impairment exhibit distinct age-related frequencies.
- Recognizing these age-specific pain patterns can significantly assist physicians in the diagnostic process.
Objective:
Pain's causes in children with severe cognitive impairment may be challenging to diagnose. This study aimed to investigate if there is a relationship between pain causes and the age of children.
Methods:
We conducted a multicenter retrospective study in three Italian Pediatric Units. Eligible subjects were patients from 1 to 18 years with severe neurological impairment. We collected data regarding diagnoses, pain causes and medical or surgical procedures. The timing of pain episodes was categorized into age-related periods: infants and toddlers (0-24 months), preschool children (3-5 years), schoolchildren (6-12 years), and adolescents (13-17 years).
Results:
Eighty children with severe neurological impairment were enrolled. The mean age was 11 years (±5.8). Gastroenterological pain was most common in the first years of life (p = 0.004), while orthopaedic and tooth pain was the most typical in schoolchildren and adolescents (p = 0.001 and p = 0.02). Concerning surgical procedures, PEG placement and gastric fundoplication were significantly more common in the first 5 years of age (p = 0.03), and heart surgery was typical of infants (p = 0.04). Orthopaedic surgery was more commonly reported in older children and adolescents (p < 0.001).
Conclusions:
Some causes of pain are more frequent in children with severe neurological impairment in defined age-related periods. Specific age-related pain frequencies may help physicians in the diagnostic approach.
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