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Pain Syndromes and Disorders of Sensation

  • Chapter
Parkinson’s Disease and Nonmotor Dysfunction

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Although routine clinical neurological examination generally does not reveal any abnormality of sensation in persons with Parkinson’s disease (PD), subjective sensory symptoms are quite frequently present, and objective abnormalities of proprioceptive function and sensorimotor integration have been demonstrated with sophisticated testing. Primary sensory symptoms of PD may include paresthesias of varied descriptions (numbness, tingling, and burning).

Painful symptoms in PD can be classified into five categories: musculoskeletal pain, radicular or neuropathic pain, dystonia-related pain, primary (central) pain, and akathitic discomfort. Musculoskeletal pain in the form of shoulder stiffness frequently develops in persons with PD, often preceding the development of more classic motor features of the condition. Spinal deformities and painful contractures may also complicate the clinical picture in individuals with PD. The postural PD deformities may predispose to the development of compressive radiculopathy and sciatica. Dystonic spasms are among the most painful symptoms that a patient with PD may experience. Dystonia most often appears as an “ off” phenomenon, but medication-induced dystonia may also occur. Primary or central pain is generated within the brain itself and is commonly characterized by bizarre, disagreeable painful sensations that are resistant to treatment. Parkinsonian akathisia is characterized by subjective inner restlessness that manifests as a constant need to move or change position, typically during “off” periods. The recognition and differentiation of parkinsonian pain from pain owing to other coincident medical conditions is vitally important for the effective diagnosis and treatment of pain in PD.

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Author information

Authors and Affiliations

  1. Department of Neurology, Columbia University, New York, NY

    Blair Ford MD, FRCP(C)

  2. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN

    Ronald F. Pfeiffer MD

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  1. Blair Ford MD, FRCP(C)
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  2. Ronald F. Pfeiffer MD
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Editors and Affiliations

  1. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN

    Ronald F. Pfeiffer MD

  2. Department of Neurology, State University of New York, Downstate Medical Center, Brooklyn, NY

    Ivan Bodis-Wollner MD, DSc

  3. Department of Ophthalmology, State University of New York, Downstate Medical Center, Brooklyn, NY

    Ivan Bodis-Wollner MD, DSc

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© 2005 Humana Press Inc., Totowa, NJ

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Ford, B., Pfeiffer, R.F. (2005). Pain Syndromes and Disorders of Sensation. In: Pfeiffer, R.F., Bodis-Wollner, I. (eds) Parkinson’s Disease and Nonmotor Dysfunction. Current Clinical Neurology. Humana Press. https://doi.org/10.1385/1-59259-859-5:255

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  • DOI: https://doi.org/10.1385/1-59259-859-5:255

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-316-9

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