Background Involuntary movements are one of the features of Huntington's disease (HD), Parkinson's disease (PD) and cervical dystonia (CD). Self-awareness of symptoms is overally deficient in HD, while in PD poor self-awareness of symptoms is related to dementia. Self-awareness of symptoms in CD is supposed to be preserved. Previous studies assessing self-awareness of chorea used questionnaire format, which may be prone to misunderstandings.

Aims The study aimed at assessing self-awareness of motor and daily disability in HD, PD with (PDdys) and without dyskinesias (PDndys) and in cervical dystonia (CD). Self-awareness was assessed by comparing patient's and caregiver's ratings and by correlating them with objective results. Film materials were used to depict specific motor symptoms.

Methods/techniques Eighty-nine patients scoring at least 20 in Mini-Mental State Examination (MMSE) participated in the study (23 with HD, 25 PD with PDdys, 21 with PDndys and 20 with CD). Neurological examination comprised of Unified Huntington's Disease Rating Scale (UHDRS) for HD, Unified Parkinson's Disease Rating Scale (UPDRS) part II-IV for PD and Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) for CD. Questionnaires filled in by the patient and his/her caregiver included: Self-Assessment Parkinson's Disease Disability Scale and a scale based on a series of 15 films demonstrating different motor symptoms (5 UHDRS, 5 UPDRS and 5 from TWSTRS).

Results/outcome HD patients overall underestimated their dysfunctions. PDdys patients both underestimated and overestimated certain aspects of motor symptoms and dysfunction in daily activities. PDndys and CD patients demonstrated better self-awareness of symptoms.

Conclusions Deficits in the self-awareness of symptoms are more generalised in HD than in PD, regardless of the cognitive status.