Reaction to pain is not always apparent among patients with Down's syndrome, but new research published in 2 December Lancet (Lancet 2000 356:1882) suggests that such individuals just express it more slowly and less precisely than the rest of us. Patients with Down's syndrome should receive pain control even in the absence of obvious pain manifestations.

A study by Martine Hennequin and colleagues from Université d'Auvergne Clermont-Ferrand Franc, and McGill University, Montreal, Canada measured the latency of pain detection in 75 control individuals and 26 patients with Down's syndrome. They found that patients with Down's syndrome had a significant longer time delay in pain detection to cold stimuli than controls (29 seconds compared to 21 seconds). These patients also had difficulty in localising a cold stimulus on the hand, face and in the mouth when compared to controls.

In the view of these results, researchers are now planning...

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