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

TITLE=Timeline of diagnosed pain causes in children with severe neurological impairment

JOURNAL=Frontiers in Pediatrics

VOLUME=12

YEAR=2024

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2024.1365152

DOI=10.3389/fped.2024.1365152

ISSN=2296-2360

ABSTRACT=<sec><title>Objective</title><p>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.</p></sec><sec><title>Methods</title><p>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).</p></sec><sec><title>Results</title><p>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 (<italic>p</italic> = 0.004), while orthopaedic and tooth pain was the most typical in schoolchildren and adolescents (<italic>p</italic> = 0.001 and <italic>p</italic> = 0.02). Concerning surgical procedures, PEG placement and gastric fundoplication were significantly more common in the first 5 years of age (<italic>p</italic> = 0.03), and heart surgery was typical of infants (<italic>p</italic> = 0.04). Orthopaedic surgery was more commonly reported in older children and adolescents (<italic>p</italic> &lt; 0.001).</p></sec><sec><title>Conclusions</title><p>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.</p></sec>