The Relationship between Pain and Spasticity and Tell-Tale Signs of Pain in Children with Cerebral Palsy

Pain and quality of life are closely interrelated in children with cerebral palsy (CCP). Even though 67% of CCP experience pain, it is overlooked and untreated. In this study, our purpose was two-fold: first, to examine the relationship between pain and spasticity by evaluating the effects of Abobot...

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Main Author: Christian Wong
Format: Article
Language:English
Published: MDPI AG 2023-02-01
Series:Toxins
Subjects:
Online Access:https://www.mdpi.com/2072-6651/15/2/152
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author Christian Wong
author_facet Christian Wong
author_sort Christian Wong
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description Pain and quality of life are closely interrelated in children with cerebral palsy (CCP). Even though 67% of CCP experience pain, it is overlooked and untreated. In this study, our purpose was two-fold: first, to examine the relationship between pain and spasticity by evaluating the effects of AbobotulinumtoxinA/Dysport (BoNT), and second, to describe the symptoms and location of pain in CCP. The subjects were 22 CCP in at least moderate pain. They were evaluated for spasticity by the modified Ashworth and Tardieu scale and for pain by the r-FLACC and the pediatric pain profile. After one injection of BoNT, the subjects were re-evaluated. We found a significant reduction in pain, but no significant relationship between the reduction of pain and spasticity. We found no association between the dose of BoNT and pain or spasticity. Pain in the lower extremity was located primarily in the hip region. The effect of ultrasound-guided intermuscular injections of BoNT suggests that pain in CCP has an extra-articular component. We found that pain in CCP manifests as specific tell-tale signs and problems in daily living. In conclusion, we found no relationship between pain and spasticity. Signs and manifestations of pain are described in detail. Lower extremity (hip) pain seems to have a soft tissue/extra-articular component.
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spelling doaj.art-56be1993867649a79d916c919ebef7202023-11-16T23:39:15ZengMDPI AGToxins2072-66512023-02-0115215210.3390/toxins15020152The Relationship between Pain and Spasticity and Tell-Tale Signs of Pain in Children with Cerebral PalsyChristian Wong0Department of Orthopedic Surgery, University Hospital of Copenhagen, 2650 Hvidovre, DenmarkPain and quality of life are closely interrelated in children with cerebral palsy (CCP). Even though 67% of CCP experience pain, it is overlooked and untreated. In this study, our purpose was two-fold: first, to examine the relationship between pain and spasticity by evaluating the effects of AbobotulinumtoxinA/Dysport (BoNT), and second, to describe the symptoms and location of pain in CCP. The subjects were 22 CCP in at least moderate pain. They were evaluated for spasticity by the modified Ashworth and Tardieu scale and for pain by the r-FLACC and the pediatric pain profile. After one injection of BoNT, the subjects were re-evaluated. We found a significant reduction in pain, but no significant relationship between the reduction of pain and spasticity. We found no association between the dose of BoNT and pain or spasticity. Pain in the lower extremity was located primarily in the hip region. The effect of ultrasound-guided intermuscular injections of BoNT suggests that pain in CCP has an extra-articular component. We found that pain in CCP manifests as specific tell-tale signs and problems in daily living. In conclusion, we found no relationship between pain and spasticity. Signs and manifestations of pain are described in detail. Lower extremity (hip) pain seems to have a soft tissue/extra-articular component.https://www.mdpi.com/2072-6651/15/2/152paincerebral palsychildrenspasticityclinical characteristics/tell-tale signs of painparental perception of pain
spellingShingle Christian Wong
The Relationship between Pain and Spasticity and Tell-Tale Signs of Pain in Children with Cerebral Palsy
Toxins
pain
cerebral palsy
children
spasticity
clinical characteristics/tell-tale signs of pain
parental perception of pain
title The Relationship between Pain and Spasticity and Tell-Tale Signs of Pain in Children with Cerebral Palsy
title_full The Relationship between Pain and Spasticity and Tell-Tale Signs of Pain in Children with Cerebral Palsy
title_fullStr The Relationship between Pain and Spasticity and Tell-Tale Signs of Pain in Children with Cerebral Palsy
title_full_unstemmed The Relationship between Pain and Spasticity and Tell-Tale Signs of Pain in Children with Cerebral Palsy
title_short The Relationship between Pain and Spasticity and Tell-Tale Signs of Pain in Children with Cerebral Palsy
title_sort relationship between pain and spasticity and tell tale signs of pain in children with cerebral palsy
topic pain
cerebral palsy
children
spasticity
clinical characteristics/tell-tale signs of pain
parental perception of pain
url https://www.mdpi.com/2072-6651/15/2/152
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