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Lucina – May 2012

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Several reports in the first decade of this century pointed to the frequency and severity of pain among children with cerebral palsy. Now (Dev Med Child Neurol 2011;53:1013–8; see also Commentary, ibid: 974–5) workers in Norway have reported on two groups of children and adolescents aged 8–18 years, a population-based group of 75 in South-East Norway and a hospital-based group of 78 in Oslo. Participants were assessed by clinical examination, interview and questionnaire. The type of cerebral palsy was recorded as bilateral spastic in 55%, unilateral spastic in 38%, dyskinetic in 6% and ataxic in 1%. The Gross Motor Function Classification System (GMFCS) level was I in 35%, II in 37%, III in 13%, IV in 5% and V in 10%. Overall, 62% of participants reported recurrent musculoskeletal pain. On the child health questionnaire pain score (0–100, where 100=no pain) the median score was 55 as reported by the child and 50 as reported by a parent. Similarly, parents assessed the effect of pain on sleep as slightly more than that reported by the children. Older participants (>14 years) were three times more likely to report recurrent musculoskeletal pain. The main site of pain was the legs (including hips) in 70%. Other sites included the lower back, neck, shoulders and arms. The complaints of pain were similar across all GMFCS levels although, on the whole, children without pain had less motor impairment. Walking …

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