RESEARCH: Pain in multiple system atrophy.

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J Neurol 1996 Feb;243(2):153-6

Pain in multiple system atrophy.

Tison F, Wenning GK, Volonte MA, Poewe WR, Henry P, Quinn NP.

Departement de Neurologie, Hopital Pellegrin, Bordeaux Cedex, France.

Pain is a recognized feature of idiopathic Parkinson's disease (IPD) but has

never been studied in multiple system atrophy (MSA), the commonest cause of

atypical parkinsonism. We retrospectively analysed histories of pain in 100

consecutive cases of clinically probable MSA. Details were obtained from the

medical records of 100 patients with MSA, comprising 82 with the

striatonigral degeneration (SND) type and 18 with the olivopontocerebellar

atrophy (OPCA) type of MSA. Pain was reported in 47% of the MSA patients. It

was classified as rheumatic in 64% of MSA patients reporting pain, sensory

in 28%, dystonic in 21%, and levodopa-related in 16%, mostly related to

off-period or diphasic dystonias. There was a mixed pain syndrome in 19% of

these patients. Pain was significantly more commonly reported by females (P

= 0.02), and by patients with levodopa-induced dyskinesias (P = 0.02). No

other clinical feature differentiated MSA patients who reported pain from

those who did not. The mean delay between disease onset and onset of pain

was 2.9 years, but pain was reported at the time of, or before, disease

onset in about 30% of patients. The overall prevalence of pain in MSA was

similar to that reported in IPD, but the distribution of pain categories was

different.

PMID: 8750553 [PubMed - indexed for MEDLINE]