Interim guidelines for the assessment and treatment of pain in children with multiple sclerosis

Catherine Stratton; Areti Vassilopoulos; J Nicholas Brenton; Kirsten Potter; Wendy Vargas; Heather Rumm; Andrea Bartels; Mary Bailey; Charles Odonkor; Sharon Stoll; E William T Zempsky; E Ann Yeh; Naila Makhani

doi:10.3389/fnins.2023.1235945

Interim guidelines for the assessment and treatment of pain in children with multiple sclerosis

Front Neurosci. 2023 Sep 14:17:1235945. doi: 10.3389/fnins.2023.1235945. eCollection 2023.

Authors

Catherine Stratton¹, Areti Vassilopoulos^{2

3}, J Nicholas Brenton⁴, Kirsten Potter⁵, Wendy Vargas^{6

7}, Heather Rumm⁸, Andrea Bartels⁹, Mary Bailey¹⁰, Charles Odonkor^{11

12}, Sharon Stoll^{9

13}, E William T Zempsky^{14

15}, E Ann Yeh^{16

17}, Naila Makhani^{2

9}

Affiliations

¹ Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
² Department of Pediatrics, Yale School of Medicine, New Haven, CT, United States.
³ Child Study Center, Yale School of Medicine, New Haven, CT, United States.
⁴ Division of Pediatric Neurology, Department of Neurology, University of Virginia Medical Center, Charlottesville, VA, United States.
⁵ Department of Physical Therapy, Tufts University, Medford, MA, United States.
⁶ Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States.
⁷ Department of Neurology, New York-Presbyterian NYP/Columbia University Irving Medical Center, New York, NY, United States.
⁸ Connecticut Chapter, National Multiple Sclerosis Society, Hartford, CT, United States.
⁹ Department of Neurology, Yale School of Medicine, New Haven, CT, United States.
¹⁰ Trinity Health of New England, Hartford, CT, United States.
¹¹ Department of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, CT, United States.
¹² Yale New Haven Health Old Saybrook Medical Center, Old Saybrook Medical Center, New Haven, CT, United States.
¹³ Yale MS Center, North Haven, CT, United States.
¹⁴ Division of Pain & Palliative Medicine, Connecticut Children's Medical Center, Hartford, CT, United States.
¹⁵ Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, United States.
¹⁶ Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
¹⁷ Division of Neuroscience and Mental Health, Department of Paediatrics (Neurology), Hospital for Sick Children, SickKids Research Institute, Toronto, ON, Canada.

Abstract

Introduction: Pain in multiple sclerosis (MS) is common, but literature on pain in children with MS remains scarce. Pain has physical, psychological, and social implications in MS, and both comprehensive assessment and interdisciplinary management approaches are needed. We sought to develop an interdisciplinary interim guideline for the assessment and management of pain in children with MS.

Methods and materials: We convened a modified Delphi panel composed of 13 experts in pediatric and adult MS neurology, physiotherapy, pain, patient lived-experience, advanced practice nursing, psychology, physiatry, and MS research. A survey was sent to panelists for anonymous completion. The panel discussed survey themes extracted by the panel chair. The process was repeated twice.

Results: Thirteen assessment and treatment recommendations were produced regarding pain in children with MS.

Discussion: Future studies will assess implementation of these pain assessment and treatment guidelines in the clinical setting.

Keywords: Delphi panel; clinical guideline; multiple sclerosis; pain; pediatrics.

Grants and funding

K23 NS101099/NS/NINDS NIH HHS/United States