Biologie synthétique et systémique actuelle
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Excessive Crying in Children with Cerebral Palsy

Nagabhushana Rao Potharaju*

Pain/discomfort is both under-suspected and underdiagnosed cause of Excessive Crying in Children with Cerebral Palsy and Communication Deficits. It has not been investigated for many decades because of the lack of understanding of the etiology, pathogenesis, pharmacology/pharmacokinetics of drugs, and ethics of the study in pediatric participants who cannot consent to the study. This is the first study to clinically and statistically design and prove a simple and practical algorithm for the management of a challenging task. Diagnosing and treating nociceptive pain at the earliest is imperative, because untreated, under-treated, or mistreated acute pain may lead to chronic pain states confounding treatment. Additionally, a vicious cycle of spasms-pain-spasms sets in as pain continues. In the long run, if the pain is not controlled, the quality of life of children with cerebral palsy and their families worsens. Managing pain in children would reduce the prevalence of chronic pain when they grow up. The drugs and their sequence of usage are decided by the subtype of CP, assumed etiology, the pathophysiology of pain/discomfort, clinical symptoms/signs, accompanying problems, electroencephalography, Magnetic Resonance Imaging (MRI), mechanism of action of the drug, side effects of the drug, and allergies. Treatment of dystonia, spasticity, neuropathic and visceral, pain reduced crying. The drug requirement was reduced after 250 days of treatment with the resolution of the vicious cycle of spasms-pain-spasms. Parents/caregivers reported simultaneous improvement in dysphagia/drool without any additional treatment.