Open AccessClassifying pain in dystonia: a way to improve pain outcome measure in dystonia
Author(s) -
Clarice Listik,
Eduardo Listik,
Jorge Dornellys da Silva Lapa,
Graziele Costa Santos,
Fabricio Vianna do Vale,
Rubens Gisbert Cury,
Manoel Jacobsen Teixeira,
João Carlos Papaterra Limongi,
Henrique Ballalai Ferraz,
Egberto Reis Barbosa,
Daniel Ciampi de Andrade
Publication year - 2021
Language(s) - English
Resource type - Conference proceedings
DOI - 10.5327/1516-3180.250
Subject(s) - dystonia , medicine , chronic pain , physical therapy , physical medicine and rehabilitation , complex regional pain syndrome , psychiatry
Background: Pain is a frequent and incapacitating non-motor symptom in dystonia. Evidence indicates that pain in dystonia is not only of muscular origin, but pain’s descending modulatory systems are impaired in dystonia. There is much to be learned about this topic. Still, we do not have a simple and straightforward way to classify, evaluate pain, and assess its improvement after pharmacological, surgical, and non-invasive treatments. Objective: To improve the classification system for pain in dystonia. Design and setting: This are the preliminary results of a multicentric study that at this moment selects patients in the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo and in the Hospital Sao Paulo da Universidade Federal de São Paulo. Methods: We evaluated 36 patients with hereditary/idiopathic dystonia of any distribution. These results are preliminary finds of this multicentric assessment. We applied the Burke-Fahn-Marsden (BFM) dystonia scale, two pain scales (Douleur Neuropathique - DN4 and the short-form Brief Pain Inventory - BPI), and our developed classification system. Results: Patients (54.9 ± 14.6 years, 41.7% male) had a BFM motor and disability subscores of 17.6 ± 6.8 and 4.5 ± 5.7, respectively, and 15 patients (41.7%) had chronic pain. Four patients had chronic pain non-related to dystonia, and 11 patients had chronic pain directly related to dystonia. Six patients had a second chronic pain, one of which was aggravated by dystonia, and five were directly associated with dystonia. DN4 was 2.1 ± 1.9, and BPI pain severity 5.2 ± 2.0 interference 5.0 ± 3.2. Conclusions: Chronic pain is prevalent in dystonic patients and is frequently directly related to dystonia.