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The causalgia-dystonia syndrome
K P Bhatia1, M H Bhatt, C D Marsden
1University Department of Clinical Neurology, Institute of Neurology, London, UK.
Brain : a Journal of Neurology
|August 1, 1993
Summary
This study describes a rare syndrome of causalgia and dystonia in 18 patients, often triggered by minor injuries. Conventional treatments were ineffective, highlighting the need for further research into this complex neurological condition.
Area of Science:
- Neurology
- Pain Medicine
- Movement Disorders
Background:
- Causalgia and dystonia are distinct neurological conditions.
- The co-occurrence of these symptoms, particularly after peripheral injury, is not well-characterized.
- Understanding this syndrome is crucial for diagnosis and treatment.
Purpose of the Study:
- To describe the clinical features of patients presenting with causalgia and dystonia.
- To investigate the onset, progression, and characteristics of this combined syndrome.
- To evaluate the effectiveness of conventional treatments and identify potential underlying mechanisms.
Main Methods:
- Retrospective case series analysis of 18 patients.
- Detailed clinical assessment including pain, sensory, motor, and autonomic symptoms.
- Review of diagnostic investigations and treatment outcomes.
Main Results:
- 18 patients (16 female, 2 male) presented with causalgia and dystonia, often post-injury.
- Symptoms included burning pain, allodynia, hyperpathia, vasomotor, sudomotor, and trophic changes.
- Dystonic spasms were sustained, leading to fixed postures, and spread to other extremities. Investigations were normal, and conventional treatments failed.
- Two patients experienced spontaneous recovery.
Conclusions:
- This syndrome presents with a unique combination of sensory, autonomic, and motor disturbances.
- The sustained dystonic posture differentiates it from idiopathic torsion dystonia.
- The etiology remains unclear, with possibilities including functional central nervous system disorder or psychogenic origin.