Validated diagnostic tools to diagnose chronic neuropathic and mixed
pain in children are missing. Therapeutic options are often derived from
therapeutics for adults. To investigate the international practice amongst practitioners for the diagnosis and treatment of chronic,
neuropathic pain in children and adolescents, we performed a survey study among members of learned societies or groups whose members are known to treat pediatric
pain. The survey included questions concerning practitioners and practice characteristics, assessment and diagnosis, treatment and medication. We analyzed 117 returned questionnaires, of which 41 (35%) were fully completed and 76 (65%) were partially completed. Most respondents based the diagnosis of
neuropathic pain on physical examination (68 (58.1%)), patient history (67 (57.3%)), and underlying disease (59 (50.4%)) combined.
Gabapentin,
amitriptyline, and
pregabalin were the first-choice treatments for moderate
neuropathic pain.
Tramadol,
ibuprofen,
amitriptyline, and
paracetamol were the first-choice treatments for moderate mixed
pain. Consensus on the diagnostic process of
neuropathic pain in children and adolescents is lacking. Drug treatment varies widely for moderate, severe neuropathic, and mixed
pain. Hence, diagnostic tools and
therapy need to be harmonized and validated for use in children.