Incapacitating pain in Parkinson’s disease: A case report

Abstract

Pain is an important manifestation of Parkinson’s Disease, with multiple mechanisms independently contributing to it. Here, we describe a case with predominant nociplastic pain. A 62-year-old woman with advanced Parkinson’s disease with motor fluctuations presented with a 6-month history of incapacitating pain. She described it as a burning sensation and tightness in her body, including the face, throat, and perineum. The pain precipitated when dopaminergic drugs wore off, lasting for 1–2 hours. Diagnosis of nociplastic pain was considered, and she was started on gabapentin along with optimization of her Parkinson’s medication; she responded to this treatment. Nonmotor manifestations could be the most incapacitating symptom, especially in advanced Parkinson’s disease. The etiology of pain in Parkinson’s disease may be difficult to identify, and its management can be challenging.

Keywords

• nociplastic pain
• nonmotor
• parkinson’s disease