Pain has a physical, psychologic, spiritual and cultural component. Individuals with mitochondrial disease report pain most commonly in the form of headaches, myalgias and neuropathy, and abdominal or chest pain. Cutaneous pain is also reported in association with Raynaud-like changes, especially in the distal extremities. Impaired function in the central nervous system may also cause pain that may be manifested in a number of different ways including painful myoclonus and spasms; impairment in the spino-thalamo-cortical system appears to be a major cause of central pain (Tanaka, 1997).
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