‘Total Pain’ in Children with Severe Neurological Impairment

• Main Authors: Timothy A. Warlow, Richard D.W. Hain
• Format: Article
• Language: English
• Published: MDPI AG 2018-01-01
• Series: Children
• Subjects: ‘Total Pain’; paediatric palliative care; chronic pain; persistent pain; cerebral palsy; cognitive impairment; neurological impairment
• Online Access: http://www.mdpi.com/2227-9067/5/1/13

Many children with palliative care needs experience difficulty in managing pain. Perhaps none more so than those with severe neurological impairment. For many years; behaviours in these children were misunderstood. As a result; pain was poorly recognised and inadequately managed. Significant advances have been made in the assessment and management of pain in this challenging group of patients. We summarise these advances; drawing on our own experience working with infants; children and young adults with palliative care needs within a UK tertiary paediatric palliative care service. We expand on the recent understanding of ‘Total Pain’; applying a holistic approach to pain assessment and management in children with severe neurological impairment.