title: Neuropathic pain other than CRPS in children and adolescents: incidence, referral, clinical characteristics, management, and clinical outcomes.
abstract: OBJECTIVE
  Chronic pain in children and adolescents is common, but proportion of neuropathic pain (NP), a heterogeneous group of diseases with major impact on health-related quality of life, significant economic burden, and limited treatment options, is unclear. Many studies have focused only on complex regional pain syndrome (CRPS). Our aim was to examine the incidence, clinical features, management, and outcome of non-CRPS NP in patients referred to a chronic pediatric pain clinic (CPPC) at a tertiary-care hospital.
  
  
  METHODS
  Retrospective analyses of the patient's files with non-CRPS NP from 2008 until 2012.
  
  
  RESULTS
  Twenty patients (9.9-22.0 years; 10.7% of new referrals) were treated with non-CRPS NP (postoperative 8/20, trauma-related 5/20, disease-related 7/20). The number of consultations performed and the number of medications used before CPPC were significantly higher than in CPPC (Z = 0.75, P = 0.005; Z = 1.68, P = 0.003; respectively, Wilcoxon test). The number of diagnostic procedures was not statistically significant. Invasive treatments were used in 50% of patients. Full/partial recovery was accomplished in 95%. anova with repeated measures yielded a highly significant difference between the initial and final visual analog scale (VAS) scores (8.2 ± 1.3; 1.19 ± 2.01, respectively; P < 0.001), and no effect of age, gender, time needed for referral to CPPC, and patient's categories on the change in VAS.
  
  
  CONCLUSIONS
  Better understanding of the medical profile of pediatric patients with non-CRPS NP is crucial to timely and correct diagnosis and effective management, but even children with delayed diagnosis still have a good outcome. The management of this condition by an experienced team is recommended.
authors.affiliation: Chronic Pain Clinic, Pain Treatment Service, Schneider Children's Medical Center of Israel (SCMCI), Petah Tiqwa, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Anesthesia, Schneider Children's Medical Center of Israel (SCMCI), Petah Tiqwa, Israel.
authors.forename: Ludmyla
authors.initials: L
authors.lastname: Kachko
authors.forename: Shiri
authors.initials: S
authors.lastname: Ben Ami
authors.forename: Alon
authors.initials: A
authors.lastname: Lieberman
authors.forename: Rita
authors.initials: R
authors.lastname: Shor
authors.forename: Elena
authors.initials: E
authors.lastname: Tzeitlin
authors.forename: Rachel
authors.initials: R
authors.lastname: Efrat
mesh_terms: D000293:Adolescent; D000639:Amitriptyline / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002648:Child; D059350:Chronic Pain / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009437:Neuralgia / Q000453:epidemiology / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000187:drug effects; D012017:Referral and Consultation; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline
keywords: adolescents; non-CRPS neuropathic pain