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

en described. To get a better sense of the possible contribution of SFPN to chronic pain in children, Oaklander and her co-author Max Klein, PhD, a research fellow in Neurology at MGH, reviewed the records of 41 patients treated by Oaklander between 2007 and 2011 for persistent widespread pain in several parts of the body that began before age 21. In a search for the cause of their symptoms, all of the patients had undergone a range of diagnostic tests at the MGH and other leading institutions.

Recommended diagnostic tests for SFPN include a type of skin biopsy that characterizes the number and condition of nerve fibers in the lower leg and autonomic function testing, including monitoring the heart rate and blood pressure when an individual breaths deeply, blows out when the airway is blocked or is placed on a tilt table. A control group of 38 age- and gender-matched volunteer children underwent the same autonomic function tests that the patients had received, and control values for neurodiagnostic skin biopsies were based on samples from healthy age- and gender-matched volunteers collected at MGH.

The analysis revealed that 24 of the 41 patients met criteria for a diagnosis of SFPN, meaning that results of at least one test clearly indicated the presence of the disease. Of the remaining 17 patients, 16 were determined to possibly or probably have SFPN, based on less seriously abnormal test results. Among the autonomic function tests, sweat production a sensitive diagnostic test for SFPN was reduced in 82 percent of patients, compared with 34 percent of controls. In contrast, results of other tests that the patients had undergone including magnetic resonance imaging, spinal taps and gastrointestinal endoscopy provided no useful diagnostic information.

Many of the patients participating in the study had reported that their symptoms began after an earlier illness or injury. A third had some history of autoimmune illnesses, and
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Contact: Mike Morrison
mdmorrison@partners.org
617-724-6425
Massachusetts General Hospital
Source:Eurekalert

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