Age-dependent development of chronic neuropathic pain, allodynia and sensory recovery after upper limb nerve injury in children.
Forty-nine children with distal upper limb nerve injury were studied at a mean follow-up of 2 years 3 months. Patients who were aged 5 years or younger at the time of nerve injury (15/49) had no chronic neuropathic pain symptoms or allodynia. Patients with allodynia on quantitative sensory testing but no spontaneous pain (8/49) were all older than 5 years and those reporting spontaneous chronic neuropathic pain (5/49) were all older than 12 years at the time of injury. Previous studies of adults with similar nerve injuries report chronic hyperaesthesia in up to 40% of cases. Semmes-Weinstein monofilament testing showed a positive correlation between age at injury and abnormal sensory threshold (r = 0.60, P<0.0001). These findings indicate that young children show better sensory recovery and are less likely to develop long-term chronic neuropathic pain syndromes than adults following nerve injury.
Atherton
Duncan D
DD
Peripheral Neuropathy Unit, Imperial College London, Hammersmith Hospital, London, UK.
Taherzadeh
Omeed
O
Elliot
David
D
Anand
Praveen
P
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006941:Hyperesthesia / Q000453:epidemiology; D007223:Infant; D008297:Male; D010147:Pain Measurement; D017288:Pain Threshold; D050500:Pancreatitis, Chronic; D010523:Peripheral Nervous System Diseases; D034941:Upper Extremity / Q000294:innervation*