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. 2022 Jan 2;9(1):45.
doi: 10.3390/children9010045.

A Pragmatic Approach to Assessment of Chronic and Recurrent Pain in Children with Severe Neurologic Impairment

Simone Benvenuto  1 , Andrea Trombetta  1 , Egidio Barbi  2
Affiliations

A Pragmatic Approach to Assessment of Chronic and Recurrent Pain in Children with Severe Neurologic Impairment

Simone Benvenuto et al. Children (Basel). .

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.

Keywords: pain; severe neurologic impairment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pain and antinociceptive system pathways. Pain amplification (red) and control (blue) factors. Modified from Panizon and Barbi. Some Specific Issues on Pain in Pediatrics: Summary and Review of the Present Knowledge and Practice. Medico e Bambino, 2010; 29:289–297. See also Reference [7].
Figure 2
Figure 2
Diagnostic workup for pain in patients with cognitive impairment. Modified from Hauer and, Houtrow, Pain Assessment and Treatment in Children with Significant Impairment of the Central Nervous System. Pediatrics 139 (2017).
See this image and copyright information in PMC

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