DIFFICULTIES IA IDENTIFYING SOURCES OF PA IN IN PEDIATRIC-PATIENTS WITH MULTIPLE DISABILITIES

Three unusual cases of pain in pediatric patients with severe, multipl e disabilities are reported. Because pediatric hetero-evaluation scale s based on observation of behavior are not appropriate for severely di sabled patients, development of a specific scale is suggested, In addi tion to emphasizing a number of diagnostic difficulties, the cases rep orted herein raise questions about the pathophysiology of nociception in children with extensive brain lesions.