Some children experience chronic pain that is related to damage or diseases that affect the nerves that send pain signals. This is known as neuropathic pain. This is not well understood and can be difficult to diagnose. It can often produce unusual feelings such as sensitivity of the skin to light touch. Neuropathic pain is often severe and difficult to treat, and can affect quality of life for the child and family. This study aims to better characterise the symptoms and signs, and impact of neuropathic pain in children.
The Investigators will determine whether a questionnaire to identify neuropathic pain in adults is also useful in children. This will help paediatricians and other doctors to recognise neuropathic pain and start appropriate treatment or know when to refer children to a chronic pain clinic.The Investigators will also measure the effects of neuropathic pain on mood, sleep, and quality of life (using questionnaires); identify changes in the sensitivity of the skin to touch and other sensations (using specialised sensory tests); and determine the feasibility of brain imaging for assessing changes in the brain (using magnetic resonance imaging or MRI), in children with neuropathic pain. This information will allow the investigators to measure how effective different types of treatment are, and help ensure children get the most appropriate treatment or interventions to reduce pain and effects on quality of life. This pilot study of 10-18 year olds diagnosed with neuropathic pain will involve completion of questionnaires by the child and parent, and sensory testing in the child, after their clinic appointment. For some families, there will be an additional visit for MRI. Children will be recruited from the Chronic Pain Outpatients service at Great Ormond Street Hospital NHS Trust. This research is funded by Great Ormond Street Hospital Children's Charity.
Study Type
OBSERVATIONAL
Enrollment
160
multiple modality testing of generalized and localized changes in somatosensory perception
magnetic resonance imaging (MRI)
neuropathic pain screening tool; validated questionnaires
IChildHealth
London, United Kingdom
Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) questionnaire
Sensitivity and specificity of a neuropathic screening tool in children; includes 5 questions related to symptoms and pain descriptors and 2 related to examination
Time frame: 3 years
Paediatric Quality of Life Inventory (Child and Parent report)
evaluates 23 items relating to the child's functioning in four dimensions: physical; emotional; social; and school.
Time frame: 3 years
Pain Catastrophizing Scale (Child and Parent versions)
13 items assessing 3 aspects of pain experience: the tendency to magnify the threat value of pain (magnification), to feel helpless in the context of pain (helplessness), and to worry about it more (rumination)
Time frame: 3 years
Pain Coping Questionnaire
comprises 39 items relating to information seeking; problem solving; seeking social support; positive self-statements; behavioural distraction; cognitive distraction; externalising; and internalising/catastrophizing
Time frame: 3 years
Adolescent Sleep-Wake Scale-Revised
evaluates 10 items relating to: falling asleep and reinitiating sleep; returning to wakefulness; and going to bed
Time frame: 3 years
Paediatric Index of Emotional Distress
comprises 14 items related to symptoms of anxiety and depression, with a maximum score of 42
Time frame: 3 years
Hospital Anxiety and Depression Scale
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measures anxiety and depression in adults (parents) and comprises 14 items
Time frame: 3 years
Quantitative Sensory Testing
Sensory profile in terms of gain or loss of sensitivity
Time frame: 3 years
Magnetic Resonance Imaging
pilot study to assess feasibility and acceptability of MRI in this patient group
Time frame: 3 years