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. 2024 Mar 6:12:1365152.
doi: 10.3389/fped.2024.1365152. eCollection 2024.

Timeline of diagnosed pain causes in children with severe neurological impairment

Francesca Peri  1   2 , Elena Magni  3 , Filippo Pigani  1 , Raffaella Romoli  4 , Simona Vetrella  5 , Lucia De Zen  2 , Raffaella Sagredini  6 , Egidio Barbi  1   2 , Giorgio Cozzi  2
Affiliations

Timeline of diagnosed pain causes in children with severe neurological impairment

Francesca Peri et al. Front Pediatr. .

Abstract

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.

Keywords: chronic pain; pain; pediatric pain; severe neurologic disorder; severe neurologic impairment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

PIE CHART 1
PIE CHART 1
Percentage of total specific pain episodes. Other = dystonia and muscle spasms.
Figure 1
Figure 1
Percentage of age-related specific pain episodes.
PIE CHART 2
PIE CHART 2
Percentage of total surgeries and medical procedures.
Figure 2
Figure 2
Percentage of age-related surgeries and medical procedures.
See this image and copyright information in PMC

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