Congenital idiopathic inability to perceive pain: a new syndrome of insensitivity to pain and itch with preserved small fibers

Pain
Paola SandroniJeffrey D Rome

Abstract

Individuals vary widely in their sensitivity to painful stimuli. Some exhibit heightened reactions to pain (hyperpathia), while others show relative indifference. Although multiple factors may be responsible for these differences, varying sensitivities to pain also can be due to underlying differences in nociceptive neurophysiology. We present here the case of an individual with an apparent congenital inability to perceive pain. This patient appears to be different from other reported cases of insensitivity to pain described in the medical literature. He exhibited no evidence of an abnormality of the peripheral or autonomic nervous system and no apparent abnormality of the central nervous system other than isolated deficits in pain and temperature perception. Since pain is a subjective phenomenon, there is no definitive way to assess this patient's reported inability to perceive painful somatic stimulation, but available evidence suggests he has a defect in the supraspinal processing of nociceptive stimuli which renders him insensitive to pain. This raises the possibility of either deficient central nociceptive functioning or aberrant endogenous anti-nociceptive functioning.

References

Jul 1, 1988·Annals of Neurology·M BerthierR Leiguarda
Feb 14, 2003·Pain·Elna M NagasakoRobert H Dworkin
Nov 1, 1959·Journal of Neurology, Neurosurgery, and Psychiatry·T E OGDENE A CARMICHAEL
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Apr 23, 2004·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·H P Rome, J D Rome

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Citations

Dec 14, 2007·The Clinical Journal of Pain·Jenny J LinCarlton Moore
Oct 19, 2007·Southern Medical Journal·Bruce Nicholson, Steven D Passik
May 24, 2008·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·D C de AndradeM J Teixeira
Sep 24, 2008·Revue neurologique·N Danziger, J-C Willer
Oct 16, 2015·International Journal of Rehabilitation Research. Internationale Zeitschrift Für Rehabilitationsforschung. Revue Internationale De Recherches De Réadaptation·Davide SattinMatilde Leonardi
May 13, 2014·The British Journal of Dermatology·F BartholomewJ M C Teng
Mar 24, 2016·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Vugar NabiyevM Cemalettin Aksoy
Apr 13, 2007·Physiological Reviews·Geoffrey Burnstock

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