Frontiers in Pediatrics (Mar 2024)

Timeline of diagnosed pain causes in children with severe neurological impairment

  • Francesca Peri,
  • Francesca Peri,
  • Elena Magni,
  • Filippo Pigani,
  • Raffaella Romoli,
  • Simona Vetrella,
  • Lucia De Zen,
  • Raffaella Sagredini,
  • Egidio Barbi,
  • Egidio Barbi,
  • Giorgio Cozzi

DOI
https://doi.org/10.3389/fped.2024.1365152
Journal volume & issue
Vol. 12

Abstract

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ObjectivePain'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.MethodsWe 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).ResultsEighty 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).ConclusionsSome 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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