A Systematic Review of Assessments and Interventions for Chronic Pain in Young Children With or at High Risk for Cerebral Palsy

• Published in: Journal of child neurology 2021-08, Vol.36 (9), p.697-710
• Main Authors: Letzkus, Lisa, Fehlings, Darcy, Ayala, Lauren, Byrne, Rachel, Gehred, Alison, Maitre, Nathalie L., Noritz, Garey, Rosenberg, Nathan S., Tanner, Kelly, Vargus-Adams, Jilda, Winter, Sarah, Lewandowski, Dennis J., Novak, Iona
• Format: Article
• Language: English
• Subjects: Cerebral Palsy - complications; Cerebral Palsy - psychology; Child, Preschool; Chronic Pain - therapy; Female; Humans; Infant; Male; Pain Measurement - methods; Pain Measurement - trends; Physical Examination - methods; Physical Examination - trends; Surveys and Questionnaires
• ISSN: 0883-0738; 1708-8283
• DOI: 10.1177/0883073821996916

Background: Pain is common in children with cerebral palsy. The purpose of this systematic review was to evaluate the evidence regarding assessments and interventions for chronic pain in children aged ≤2 years with or at high risk for cerebral palsy. Methods: A comprehensive literature search was performed. Included articles were screened using PRISMA guidelines and quality of evidence was reviewed using best-evidence tools by independent reviewers. Using social media channels, an online survey was conducted to elicit parent preferences. Results: Six articles met criteria. Parent perception was an assessment option. Three pharmacologic interventions (gabapentin, medical cannabis, botulinum toxin type A) and 1 nonpharmacologic intervention were identified. Parent survey report parent-comfort and other nonpharmacologic interventions ranked as most preferable. Conclusion: A conditional GRADE recommendation was in favor of parent report for pain assessment. Clinical trials are sorely needed because of the lack of evidence for safety and efficacy of pharmacologic interventions.