Abstract
Neck pain in the suboccipital and paracervical region ('coathanger' configuration) is often reported by patients with autonomic failure and orthostatic hypotension. The frequency of this pain, along with pains in the buttock and calf regions, was determined by questionnaire in two major groups with primary chronic autonomic failure--pure autonomic failure (PAF) and multiple system atrophy (MSA). Comparisons were made with Parkinson's disease, cerebellar degeneration and other disorders in which neurological symptoms overlap but in which there was neither autonomic failure nor orthostatic hypotension. Neck pain was present in 93% of patients with PAF, 51% of patients with MSA and 38-47% of the non-autonomic groups. Buttock pain was present in smaller but similar proportions (8-19%) of each group, like calf pain (23-37%). Neck pain in PAF and MSA differed from that in the other groups in being relieved by sitting or lying flat and in being associated with factors that lower blood pressure in these patients. Buttock pain was posturally related in PAF and MSA; for calf pain there was no difference between groups. Neck pain was related to the degree of orthostatic hypotension; in PAF patients, whose postural blood-pressure fall was greater than that in MSA, there was a greater frequency of neck pain.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Marinković Z., Kostić V., Coviković-Sternić N., Marinković S. Bol kod obolelih od Parkinsonove bolesti. Srp Arh Celok Lek. 1990 Nov-Dec;118(11-12):463–466. [PubMed] [Google Scholar]
- Mathias C. J. Autonomic disorders and their recognition. N Engl J Med. 1997 Mar 6;336(10):721–724. doi: 10.1056/NEJM199703063361010. [DOI] [PubMed] [Google Scholar]
- Mathias C. J. Orthostatic hypotension: causes, mechanisms, and influencing factors. Neurology. 1995 Apr;45(4 Suppl 5):S6–11. [PubMed] [Google Scholar]
- Robertson D., Kincaid D. W., Haile V., Robertson R. M. The head and neck discomfort of autonomic failure: an unrecognized aetiology of headache. Clin Auton Res. 1994 Jun;4(3):99–103. doi: 10.1007/BF01845772. [DOI] [PubMed] [Google Scholar]