MODERN VIEW OF DIAGNOSIS AND APPROACHES TO THE TREATMENT OF CHRONIC PAIN IN CHILDREN WITH PARALYTIC SYNDROMES (LITERATURE REVIEW)

Over the past decades, more and more attention in medical science has been paid to the diagnosis and study of pain mechanisms in the pediatric population. According to experts in the field of chronic pain in children, it occurs in 12% of all pediatric patients, which negatively affects the quality of children’s life and life of their families. Today, a particularly important problem in most countries of the world is pain in children with paralytic syndromes of III - V level according to GMFCS. About 20-35% of children with paralytic syndromes suffer from chronic pain. Although there are means and knowledge on how to treat pain, children's pain is often not recognized, ignored, or even denied. More than 50% of children with paralytic syndromes suffer from moderate to severe pain daily and in several parts of the body. The International Association for the Study of Pain (IASP) defines pain as “an unpleasant, sensual, and emotional experience associated with actual or potential tissue damage or perceived tissue damage. The inability to communicate verbally does not negate the possibility that the individual is in pain and needs appropriate analgesic treatment. Pain is always subjective ... ". Determining the type of pain helps to identify its cause, which can guide the choice of treatment. The main cause of pain in children includes acute nociceptive pain (ie pain caused by activation of peripheral nerve endings, including somatic and visceral pain), neuropathic pain (ie due to damage or dysfunction of the somatosensory system), psychosocial - spiritual - emotional pain. Chronic pain is a continuous or intermittent pain that lasts longer than the expected normal recovery period. Chronic pain can also occur and persist in the absence of a specific pathophysiology or medical condition. The expression of pain depends on a child's age, cognitive development and socio-cultural context.