title: Assessing and treating pain associated with stroke, multiple sclerosis, cerebral palsy, spinal cord injury and spasticity. Evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation.
abstract: Pain is a common and disabling symptom in patients with stroke, multiple sclerosis (MS), cerebral palsy (CP), spinal cord injury (SCI) and other conditions associated with spasticity, but data on its prevalence, and natural history, as well as guidelines on its assessment and treatment in the field of neurorehabilitation, are largely lacking. The Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) searched and evaluated current evidence on the frequency, evolution, predictors, assessment, and pharmacological and non-pharmacological treatment of pain in patients with stroke, MS, CP, SCI and other conditions associated with spasticity. Patients with stroke, MS, CP, and SCI may suffer from pain related to spasticity, as well as nociceptive and neuropathic pain (NP), whose prevalence, natural history, impact on functional outcome, and predictors are only partially known. Diagnosis and assessment of the different types of pain in these patients is important, because their treatment may differ. Botulinum neurotoxin is the first choice treatment for spasticity, while some antidepressant and antiepileptic drugs may be effective on NP, but pharmacological treatment varies according to the underlying disease. In most cases, a single therapy is not sufficient to treat pain, and a multidisciplinary approach, which include pharmacological and non-pharmacological treatments is needed. Further studies, and in particular randomized controlled trials, are needed on these topics.
authors: IRCCS Santa Lucia Foundation, Rome, Italy - s.paolucci@hsantalucia.it.
authors: Stefano
authors: S
authors: Paolucci
authors: IRCCS E. Medea Scientific Institute, Conegliano, Treviso, Italy.
authors: Andrea
authors: A
authors: Martinuzzi
authors: IRCCS Santa Lucia Foundation, Rome, Italy.
authors: Giorgio
authors: G
authors: Scivoletto
authors: Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.|Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
authors: Nicola
authors: N
authors: Smania
authors: Neurology Unit, Head and Neck Department, ASL 3 Genovese, Genoa, Italy.
authors: Claudio
authors: C
authors: Solaro
authors: Don Gnocchi Foundation, Milan, Italy.
authors: Irene
authors: I
authors: Aprile
authors: Department of Neuroscience and Neurorehabilitation, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.
authors: Michela
authors: M
authors: Armando
authors: C. Mondino National Neurological Institute, Pavia, Italy.
authors: Roberto
authors: R
authors: Bergamaschi
authors: C. Mondino National Neurological Institute, Pavia, Italy.
authors: Eliana
authors: E
authors: Berra
authors: Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.|Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
authors: Giulia
authors: G
authors: Berto
authors: IRCCS E. Medea Scientific Institute, Conegliano, Treviso, Italy.
authors: Elena
authors: E
authors: Carraro
authors: Neurology Unit, Head and Neck Department, ASL 3 Genovese, Genoa, Italy.
authors: Monica
authors: M
authors: Cella
authors: Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.|Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
authors: Marialuisa
authors: M
authors: Gandolfi
authors: IRCCS Santa Lucia Foundation, Rome, Italy.
authors: Marcella
authors: M
authors: Masciullo
authors: IRCCS Santa Lucia Foundation, Rome, Italy.
authors: Marco
authors: M
authors: Molinari
authors: Developmental Neurology Unit, C. Besta Neurological Institute Foundation, Milan, Italy.
authors: Emanuela
authors: E
authors: Pagliano
authors: Don Gnocchi Foundation, Milan, Italy.
authors: Cristiano
authors: C
authors: Pecchioli
authors: Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.|Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
authors: Laura
authors: L
authors: Roncari
authors: IRCCS Santa Lucia Foundation, Rome, Italy.
authors: Monica
authors: M
authors: Torre
authors: Neurology Unit, Head and Neck Department, ASL 3 Genovese, Genoa, Italy.|Department of Experimental Medicine, Section of Diagnostic Radiology, University of Genoa, Genoa, Italy.
authors: Erika
authors: E
authors: Trabucco
authors: Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.|Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
authors: Gabriella
authors: G
authors: Vallies
authors: Hand Surgery Department, Santa Maria Hospital, Multimedica, Castellanza, Varese, Italy.
authors: Paolo
authors: P
authors: Zerbinati
authors: Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
authors: Stefano
authors: S
authors: Tamburin
mesh_terms: D002547:Cerebral Palsy / Q000150:complications*; D019317:Evidence-Based Medicine; D006801:Humans; D007558:Italy; D009103:Multiple Sclerosis / Q000150:complications*; D009128:Muscle Spasticity / Q000150:complications*; D009437:Neuralgia / Q000209:etiology* / Q000534:rehabilitation*; D000066530:Neurological Rehabilitation / Q000379:methods*; D059226:Nociceptive Pain / Q000209:etiology* / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D013119:Spinal Cord Injuries / Q000150:complications*; D020521:Stroke / Q000150:complications*; D057170:Translational Research, Biomedical