TABLE 1

Definitions

PainDefined by the IASP2 as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. The inability to communicate verbally does not negate the possibility that an individual is experiencing pain and is in need of appropriate pain-relieving treatment”
Pain behaviorsObservable features expressed by an individual in pain, with features specific to children with SNI indicated in Table 3
Nociceptive painDefined by the IASP2 as “pain that arises from actual or threatened damage to nonneural tissue and is due to the activation of nociceptors”
Indicates tissue injury or inflammation
Neuropathic painDefined by the IASP2 as “pain that arises from an alteration or disease in the somatosensory nervous system”
Attributable to alterations in the peripheral nervous system or CNS, resulting in abnormal excitability
DysesthesiaDefined by the IASP2 as “an unpleasant sensation, whether spontaneous or evoked” with cases including hyperalgesia and allodynia
HyperalgesiaDefined by the IASP2 as “increased pain from a stimulus that normally provokes pain”
AllodyniaDefined by the IASP2 as “pain due to a stimulus that does not normally provoke pain”
AgitationUnpleasant state of arousal manifesting as irritability, restlessness, and increased motor activity3
Features include loud speech, crying, increased movement, increased autonomic arousal, such as sweating and tachycardia, inability to relax, and disturbed sleep-rest pattern
IrritabilityA disorder characterized by an abnormal responsiveness to stimuli or physiologic arousal; may be in response to pain, fright, a drug, an emotional situation, or a medical condition4
NeuroirritabilityMight best be used to indicate children with SNI who have persistent or recurrent episodes with pain behaviors after assessment and management of potential nociceptive sources, suggesting the CNS as a source of persistent pain features
  • IASP, International Association for the Study of Pain.