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Nerve damage may underlie widespread, unexplained chronic pain in children
Date:3/11/2013

Massachusetts General Hospital (MGH) investigators have described what may be a newly identified disease that appears to explain some cases of widespread chronic pain and other symptoms in children and young adults. Their report that will appear in the April issue of the journal Pediatrics, and has received early online release, finds that most of a group of young patients seen at the MGH for chronic, unexplained pain had test results indicating small-fiber polyneuropathy, a condition not previously reported in children. The MGH investigators call this new syndrome juvenile-onset small-fiber polyneuropathy or JOSeFINE.

"We've found the beginnings of a way to better evaluate young patients with otherwise unexplained widespread body pain," says Anne Louise Oaklander, MD, PhD, director of the Nerve Injury Unit in the MGH Department of Neurology and corresponding author of the Pediatrics paper. "By identifying the tests that are useful for diagnosing this condition, we hope to reduce the use of unnecessary, expensive, sometimes painful and potentially harmful testing that many of these children have undergone."

Small-fiber polyneuropathy (SFPN) involves widespread damage to the type of nerve fibers that carry pain signals from the skin and also control autonomic functions such as heart rate, blood pressure and sweating. Most commonly associated with diabetes, SFPN can be caused by other disorders in older adults or by exposure to toxic substances. Typical symptoms include chronic pain in several parts of the body, often beginning in the feet or lower legs, along with symptoms of autonomic dysfunction such as gastrointestinal problems, dizziness or fainting when standing, rapid heart rate, and changes in the appearance of skin. Specific diagnostic criteria have been established for SFPN, and accurate diagnosis can guide appropriate treatment choice.

Although polyneuropathy has been considered rare in children, occasional cases have be
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Contact: Mike Morrison
mdmorrison@partners.org
617-724-6425
Massachusetts General Hospital
Source:Eurekalert

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