Effectiveness of gabapentin in the management of chronic pain in patients with dystonic cerebral palsy: a systematic review
Main Article Content
Keywords
gabapentin, dystonic cerebral palsy, chronic pain, systematic review, pediatric population
Abstract
Introduction: Dystonic cerebral palsy (DCP) is characterized by abnor- malities in muscle tone and involuntary contractions, which lead to significant chronic pain. Gabapentin, a neuromodulatory agent, has shown benefits in pain management in pediatric populations; however, its effectiveness in DCP still requires systematic evaluation. Materials or Patients and Methods: A systematic review was conducted following PRISMA guidelines, including all articles from MEDLINE, LILACS, CINAHL, ScienceDirect, Cochrane, and Web of Science databases up to September 2024. Studies were included if they involved patients diagnosed with DCP who experienced pain, used gabapentin, and assessed pain reduction, according to the PICOS model. Risk of bias was assessed using adapted JBI and ROBINS-I tools. Results: Of 167 studies identified, three met the inclusion criteria: one pilot study, one retros- pective observational study, and one pre-post intervention study. The studies reported pain reduction with gabapentin doses of at least 30 mg/kg/day, using assessment tools such as the Pediatric Pain Profile (PPP) and the International Classification of Functioning (ICF-CY). However, methodological limitations were noted, including the predominant use of subjective measures and lack of standardization in assessment tools. Conclusion: Despite the limited number of studies, the findings suggest a potential role for gabapentin in the management of pain in patients with DCP. Nevertheless, current evidence is constrained by methodological limitations and risk of bias, highlighting the need for controlled clinical trials and more objective assessment tools to strengthen the evidence and optimize clinical application.
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