Managing Irritability and Nonoperative Pain in the Noncommunicative Child with Cerebral Palsy

Abstract

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Children with cerebral palsy (CP) have many reasons to experience pain, including those that are common to all children (such as trauma, ear infection) and many that are associated with their disability (such as spasticity, hip dislocation, or fragility fractures). For children with CP who cannot communicate their experience of pain, the challenge is great for those who care for them to recognize they are experiencing something unpleasant and unusual and to evaluate what the cause may be. In this chapter, we review many of the potential causes of pain and discomfort in this population, the various ways to evaluate the severity of pain in a noncommunicative child, and various treatment measures. We also provide illustrative case histories to highlight the challenges these patients can present.