PRINCIPLES OF THE THERAPY OF PAIN SYNDROME IN CHILDREN WITH ORTHOPEDONEUROLOGICAL COMPLICATIONS OF SPASTIC FORMS OF CEREBRAL PALSY

Pain syndromes in the practice of a pediatric neurologist are a common thread among many nosologies, which help with is needed both at ambulatory and hospital care. One of the most difficult patients with pain syndrome to manage and most frequently encountered in routine neurological practice are children with spastic forms of cerebral palsy. Nowadays in pain therapy there are four groups of methods: non-drug, drug, minimally invasive and surgical treatment. Non-drug techniques include physical therapy, mechanotherapy, massage, reflexology, positioning using orthopedic devices, hardware physiotherapy, as well as methods targeting to optimize the psychological state. In the absence of positive dynamics, drug therapy is used. It includes non-narcotic analgesics, non-steroidal anti-inflammatory drugs, muscle relaxants, α2-adrenergic receptor agonists, benzodiazepines, anticonvulsants, antidepressants and drugs intended for palliative care patients. In unpromising cases they resort to functional neurosurgery.