Article Text

Download PDFPDF
Hyperacusis in patients with complex regional pain syndrome related dystonia
  1. M J M de Klaver1,
  2. M A van Rijn1,
  3. J Marinus1,
  4. W Soede2,
  5. J A P M de Laat2,
  6. J J van Hilten1
  1. 1
    Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
  2. 2
    Audiological Centre, Leiden University Medical Centre Leiden, the Netherlands
  1. Dr J J van Hilten, Department of Neurology, Leiden University Medical Centre, PO Box 9600, NL-2300 RC Leiden, the Netherlands; J.J.van_Hilten{at}


Introduction: In complex regional pain syndrome type 1 (CRPS-1), patients may have manifestations of central involvement, including allodynia, hyperalgesia or dystonia. We noted that more severely affected patients may experience hyperacusis, which may also reflect central involvement. The aim of this study was to evaluate the occurrence and characteristics of hyperacusis in patients with CRPS related dystonia.

Methods: The presence of hyperacusis, speech reception thresholds (SRT), pure-tone thresholds (PTT) and uncomfortable loudness (UCL) was evaluated in 40 patients with CRPS related dystonia.

Results: PTT and SRT were normal for all patients. 15 patients (38%) reported hyperacusis and this was associated with allodynia/hyperalgesia and with more affected extremities. UCLs of patients with hyperacusis were significantly lower than UCLs of patients without hyperacusis.

Conclusion: Hyperacusis is common among severely affected patients with CRPS related dystonia and may indicate that the disease spreads beyond those circuits related to sensory–motor processing of extremities.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding: The project was supported by a grant from the Dutch Government (BSIK03016).

  • Competing interests: None.

  • Abbreviations:
    complex regional pain syndrome
    Fletcher Index
    Pain Coping and Cognition List
    pure-tone threshold
    speech reception threshold
    uncomfortable loudness