Acute and chronic pain in nonverbal children with neurological disorders. Possibilities of diagnosis and treatment. Systematic review

Acute and chronic pain in nonverbal children with severe pathologies of the central nervous system, including infantile cerebral palsy, is the most common and significant problem that is underestimated throughout the life of these patients. The underestimation of the importance of diagnosing pain and its treatment leads to significant damage to their physical, social and mental well-being. Obstacles to the diagnosis and treatment of pain are the uncertainty in the definition of the fact of the presence of acute pain, the degree of its intensity and the lack of reliable tools for assessing the impact of chronic pain on the quality of life of patients with severe neurological diseases. Problems of pain treatment, along with limited experience with the use of analgesics and adjuvants in this category of patients, are also concerns about the legitimacy of the use of certain drugs. In this review, we analyzed the problem of the current state of diagnosis and treatment of acute and chronic pain in nonverbal patients with severe neurological pathology and formed the main solutions.