Julie Hauer1, Daniel Mackey. 1. Department of General Pediatrics, Children's Hospital Boston, Boston, MA 02115, USA. julie.hauer@childrens.harvard.edu
Abstract
BACKGROUND: Infants with neurologic impairment (NI) as a result of injury to the central nervous system have a significant rate of pain. Problems associated with pain in children with NI include increased tone. This secondary hypertonia may contribute to apnea as a result of alterations in airway tone and chest wall movement. Infants are at greatest risk given their smaller airways, lower functional residual capacity, and the high rate of unrecognized pain at this age. DISCUSSION: We report two cases of infants with NI, identified to have significant improvement in apnea following empiric treatment with gabapentin for presumed central pain and/or visceral hyperalgesia. This correlation between pain and apnea, with resolution in apnea following effective treatment of these presumed sources, has not been previously reported in the literature. CONCLUSION: Infants with NI and apnea should have careful pain assessment and treatment, when considering other causes and interventions for apnea.
BACKGROUND:Infants with neurologic impairment (NI) as a result of injury to the central nervous system have a significant rate of pain. Problems associated with pain in children with NI include increased tone. This secondary hypertonia may contribute to apnea as a result of alterations in airway tone and chest wall movement. Infants are at greatest risk given their smaller airways, lower functional residual capacity, and the high rate of unrecognized pain at this age. DISCUSSION: We report two cases of infants with NI, identified to have significant improvement in apnea following empiric treatment with gabapentin for presumed central pain and/or visceral hyperalgesia. This correlation between pain and apnea, with resolution in apnea following effective treatment of these presumed sources, has not been previously reported in the literature. CONCLUSION:Infants with NI and apnea should have careful pain assessment and treatment, when considering other causes and interventions for apnea.
Authors: Hibo H Abdi; Nathalie L Maitre; Kristen L Benninger; Mark E Hester; Jonathan L Slaughter Journal: Pediatr Neurol Date: 2019-02-21 Impact factor: 3.372
Authors: Laura Edwards; Stephen DeMeo; Chi D Hornik; C Michael Cotten; P Brian Smith; Carolyn Pizoli; Julie M Hauer; Margarita Bidegain Journal: J Pediatr Date: 2015-11-11 Impact factor: 4.406