What can post‐stroke central pain teach us about chronic pain in adolescents with cerebral palsy?

2021 ◽  
Author(s):  
Andrew Chih Wei Huang
Keyword(s):  
Chronic Pain ◽  
Cerebral Palsy ◽  
Central Pain ◽  
Post Stroke

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

2021 ◽  
pp. 088307382199691
Author(s):  
Lisa Letzkus ◽  
Darcy Fehlings ◽  
Lauren Ayala ◽  
Rachel Byrne ◽  
Alison Gehred ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Cerebral Palsy ◽  
High Risk ◽  
Online Survey ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Parent Report ◽  
Medical Cannabis ◽  
Nonpharmacologic Intervention

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.

scholarly journals Botulinum Toxin A Treatment for Chronic Pain in Cerebral Palsy Patients

2007 ◽  
Vol 44 (7) ◽  
pp. 398-401
Author(s):  
Makoto RYU ◽  
Hideaki KUBOTA ◽  
Yutaka OKETANI ◽  
Yumi ITO ◽  
Hiromichi HARA
Keyword(s):  
Chronic Pain ◽  
Cerebral Palsy ◽  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Toxin A

scholarly journals The effects of propranolol on heart rate variability and quantitative, mechanistic, pain profiling: a randomized placebo-controlled crossover study

2018 ◽  
Vol 18 (3) ◽  
pp. 479-489 ◽  
Author(s):  
Kristian Kjær Petersen ◽  
Hjalte Holm Andersen ◽  
Masato Tsukamoto ◽  
Lincoln Tracy ◽  
Julian Koenig ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Chronic Pain ◽  
Pain Sensitivity ◽  
Experimental Pain ◽  
Central Pain ◽  
Healthy Male ◽  
Pain Pathways ◽  
Β Blocker ◽  
Chronic Pain Conditions

AbstractBackground and aimsThe autonomic nervous system (ANS) is capable of modulating pain. Aberrations in heart rate variability (HRV), reflective of ANS activity, are associated with experimental pain sensitivity, chronic pain, and more recently, pain modulatory mechanisms but the underlying mechanisms are still unclear. HRV is lowered during experimental pain as well as in chronic pain conditions and HRV can be increased by propranolol, which is a non-selective β-blocker. Sensitization of central pain pathways have been observed in several chronic pain conditions and human mechanistic pain biomarkers for these central pain pathways include temporal summation of pain (TSP) and conditioned pain modulation (CPM). The current study aimed to investigate the effect of the β-blocker propranolol, and subsequently assessing the response to standardized, quantitative, mechanistic pain biomarkers.MethodsIn this placebo-controlled, double-blinded, randomized crossover study, 25 healthy male volunteers (mean age 25.6 years) were randomized to receive 40 mg propranolol and 40 mg placebo. Heart rate, blood pressure, and HRV were assessed before and during experimental pain tests. Cuff pressure pain stimulation was used for assessment of pain detection (cPDTs) and pain tolerance (cPTTs) thresholds, TSP, and CPM. Offset analgesia (OA) was assessed using heat stimulation.ResultsPropranolol significantly reduced heart rate (p<0.001), blood pressure (p<0.02) and increased HRV (p<0.01) compared with placebo. No significant differences were found comparing cPDT (p>0.70), cPTT (p>0.93), TSP (p>0.70), OA-effect (p>0.87) or CPM (p>0.65) between propranolol and placebo.ConclusionsThe current study demonstrated that propranolol increased HRV, but did not affect pressure pain sensitivity or any pain facilitatory or modulatory outcomes.ImplicationsAnalgesic effects of propranolol have been reported in clinical pain populations and the results from the current study could indicate that increased HRV from propranolol is not associated with peripheral and central pain pathways in healthy male subjects.

Clinician Perspectives of Chronic Pain Management in Children and Adolescents with Cerebral Palsy and Dyskinesia

2020 ◽  
pp. 1-15
Author(s):  
Clare McKinnon ◽  
Jennifer White ◽  
Prue Morgan ◽  
Adrienne Harvey ◽  
Catherine Clancy ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cerebral Palsy ◽  
Pain Management ◽  
Children And Adolescents ◽  
Chronic Pain Management ◽  
Clinician Perspectives

scholarly journals Chronic Pain in Inflammatory Arthritis: Mechanisms, Metrology, and Emerging Targets—A Focus on the JAK-STAT Pathway

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Fausto Salaffi ◽  
Giovanni Giacobazzi ◽  
Marco Di Carlo
Keyword(s):  
Central Nervous System ◽  
Chronic Pain ◽  
Inflammatory Arthritis ◽  
Inflammatory Process ◽  
Pain Processing ◽  
Central Pain ◽  
The Central Nervous System ◽  
Central Pain Processing ◽  
Processing Mechanisms ◽  
Stat Pathway

Chronic pain is nowadays considered not only the mainstay symptom of rheumatic diseases but also “a disease itself.” Pain is a multidimensional phenomenon, and in inflammatory arthritis, it derives from multiple mechanisms, involving both synovitis (release of a great number of cytokines) and peripheral and central pain-processing mechanisms (sensitization). In the last years, the JAK-STAT pathway has been recognized as a pivotal component both in the inflammatory process and in pain amplification in the central nervous system. This paper provides a summary on pain in inflammatory arthritis, from pathogenesis to clinimetric instruments and treatment, with a focus on the JAK-STAT pathway.

scholarly journals The lived experience of chronic pain and dyskinesia in children and adolescents with cerebral palsy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Clare T. McKinnon ◽  
Jennifer H. White ◽  
Prue E. Morgan ◽  
Giuliana C. Antolovich ◽  
Catherine H. Clancy ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cerebral Palsy ◽  
Children And Adolescents ◽  
Lived Experience

Managing Chronic Pain in a Cerebral Palsy Patient: A Case Report

PM&R ◽  
2013 ◽  
Vol 5 ◽  
pp. S309-S309
Author(s):  
Melissa E. Xenidis ◽  
Jeffrey E. Oken
Keyword(s):  
Chronic Pain ◽  
Cerebral Palsy ◽  
Case Report ◽  
Cerebral Palsy Patient

Seizure induced by repetitive transcranial magnetic stimulation for central pain: Adapted guidelines for post-stroke patients

2017 ◽  
Vol 10 (4) ◽  
pp. 862-864 ◽  
Author(s):  
Mélanie Cogné ◽  
Cédric Gil-Jardiné ◽  
Pierre-Alain Joseph ◽  
Dominique Guehl ◽  
Bertrand Glize
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Central Pain ◽  
Stroke Patients ◽  
Post Stroke
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