Developmental Medicine and Child Neurology
Introduction: This analysis determined the prevalence and intensity of spasticity-related pain (SRP) in children/adolescents (C/As) with cerebral palsy (CP).
Patients and methods: Baseline data from the prospective incobotulinumtoxinA trials TIM, TIMO and XARA were pooled. In all three studies, SRP was assessed in C/As aged 2–17 years with lower limb (LL) and/or upper limb (UL) spasticity using the Questionnaire on Pain caused by Spasticity (QPS); both self-reports (direct or via interviewer) and parent/caregiver (P/C) observer reports were included. A C/A was considered to have SRP if any QPS key item score was rated >0 at baseline. Individual QPS modules were descriptively analyzed.
Results: At baseline, 331 and 155 C/As and 841 and 444 P/Cs completed at least one item of the relevant LL and UL QPS module, respectively. The presence of LL or UL SRP with at least one activity at baseline was respectively reported by 81.9% and 69.7% of C/As and observed by 85.9% and 77.7% of P/Cs. For both LL and UL SRP, frequency and intensity were higher with more demanding activities, irrespective of who completed the QPS. P/Cs indicated that SRP altered many of their child's behaviors, such as activity level, posture, mood, facial expression, eating, sleeping and interactions with others.
Conclusion: This pooled analysis indicates that most C/As with CP and LL and/or UL spasticity experience SRP, which is associated with more demanding activities. This emphasizes the need for effective, early and long-term pain management in C/As with CP.
Heinen F, Bonfert M, Kanovsky P, Schroeder AS, Chambers H, Dabrowski E, et al. Prevalence of spasticity-related pain in children/adolescents with cerebral palsy. Dev Med Child Neurol. 2022 May;64(Suppl 3):90-91. doi:10.1111/dmcn.15215.