Pain and cervical dystonia

Abstract

Dystonia is ahyperkinetic movement disorder that results in twisting, cramps and tremors due to sustained or intermittent muscle contractions. Cervical dystonia is the most common form of dystonia, in which the head, neck and/or shoulder areas are affected. In addition to these motor symptoms, pain and psychiatric symptoms are frequent in (cervical) dystonia. Description of the incidence and evaluation of pain in cervical dystonia, summary and discussion of treatment options and effects. In this review article the results in the scientific literature on pain in dystonia are summarized and discussed. Compared to other forms of dystonia, pain occurs most frequently in patients with cervical dystonia. Alarge proportion of patients with cervical dystonia suffer from pain, which contributes most to impairment of the patient. The motor symptoms of dystonia are usually treated with botulinum toxin injections. These have amuscle relaxing effect and also relieve pain. The study situation on the occurrence and treatment of pain in other forms of dystonia is so far very limited. Pain can dominate the clinical picture in patients with cervical dystonia. Evaluation of pain in cervical dystonia can be performed using standardized questionnaires. It is important to ask patients with cervical dystonia about pain and to consider it in treatment planning and evaluation. Vice versa, if pain is present the possibility of a causative dystonia should also be considered. For pain assessment there are some newly developed questionnaires to assess pain in astandardized way in patients with dystonia. Further research is needed to better understand the pathomechanisms of pain in dystonia.