Gabapentin for Treatment of Pain in Children with Severe Neurological Impairment
Lead Investigator:
Dr. Hal Siden
Co-Investigators and Collaborators
Dr. Tim Oberlander, Dr. Julie Hauer, Erin Adams
About the Project
Children with severe neurological impairment can experience a type of pain that does not conform to the standard definition. Because of their impairment, these children are unable to describe the site of their pain. We call this sensation Pain and Irritability of Unknown Origin (PIUO). Standard pain treatments have been unsuccessful in alleviating PIUO. Gabapentin, an anti-convulsant drug, has been used since the 1990s as a reliever of chronic, complex pain, and has shown to be safe for use in children. Although gabapentin has been used as an analgesic for over 20 years, there is a lack of prospective research investigating the properties and actions of this treatment. We hope that our study will elucidate details about the drug, including its efficacy in treating PIUO, optimal dosage, latency period, tolerability and safety.
We are promoting individualized medicine in this study by using a methodology known as N-of-1, where each participant receives both drug and placebo and thereby serves as their own control in a comparative design. We hope that this trial will help us both evaluate gabapentin as a drug and refine the n-of-1 approach that can then be applied to the several other medications used empirically for PIUO. We also hope that it will provide useful, individualized information about every participating child.