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== Hyperpathia ==
{{Infobox medical condition
| name = Hyperpathia
| image = <!-- Add relevant image if available -->
| caption = <!-- Image caption -->
| field = [[Neurology]]
| symptoms = Exaggerated pain response, [[allodynia]], [[hyperalgesia]]
| causes = [[Nerve injury]], [[neuropathy]], [[central nervous system]] disorders
| diagnosis = Clinical evaluation, [[neurological examination]]
| treatment = [[Medications]], [[physical therapy]], [[nerve blocks]]
| prognosis = Variable, depending on underlying cause
}}


'''Hyperpathia''' is a clinical phenomenon observed in certain [[neurological disorders]], where there is an amplified response to [[nociception|nociceptive stimuli]], leading to exaggerated pain sensations. Distinguishing it from other pain syndromes is essential for both diagnosis and treatment, particularly from conditions like [[allodynia]], in which non-painful stimuli elicit pain.
==Overview==
'''Hyperpathia''' is a [[neurological disorder]] characterized by an exaggerated and often painful response to stimuli that would not normally provoke pain. It is considered a type of [[dysesthesia]], which is an abnormal sensation. Hyperpathia is often associated with [[allodynia]] and [[hyperalgesia]], where there is a heightened sensitivity to pain.


== Definition ==
==Pathophysiology==
Hyperpathia occurs due to dysfunction in the [[nervous system]], particularly involving the [[central nervous system]] and [[peripheral nerves]]. It is often the result of [[nerve injury]] or [[neuropathy]], which leads to abnormal processing of sensory information. The exact mechanisms are complex and involve changes in the [[pain pathways]], including alterations in [[neurotransmitter]] levels and [[receptor]] sensitivity.


The International Association for the Study of Pain (IASP) provides a clear definition for hyperpathia:
==Causes==
''A painful syndrome characterized by an abnormally painful reaction to a stimulus, especially repetitive ones, coupled with an increased threshold.'' This definition also encompasses various accompanying features such as potential occurrence with [[allodynia]], [[hyperesthesia]], [[hyperalgesia]], or [[dysesthesia]]. Certain peculiarities might be associated, like inaccurate identification or localization of stimuli, delayed responses, sensations that radiate, and lingering after-sensations, with the pain frequently manifesting explosively.<ref>(I.A.S.P, 1986). Pain Supplement 3: Classification of Chronic Pain, Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms. Amsterdam: Elsevier.</ref>
Hyperpathia can be caused by a variety of conditions, including:
* [[Peripheral neuropathy]]
* [[Central nervous system]] disorders such as [[multiple sclerosis]]
* [[Post-herpetic neuralgia]]
* [[Diabetic neuropathy]]
* [[Complex regional pain syndrome]]
* [[Spinal cord injury]]


<youtube>
==Symptoms==
title='''{{PAGENAME}}'''
The primary symptom of hyperpathia is an exaggerated pain response to stimuli. Patients may experience:
movie_url=http://www.youtube.com/v/zfqqi-sWZPQ
* Intense pain from light touch or pressure
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* Burning or tingling sensations
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* Pain that persists longer than the stimulus
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* Difficulty in localizing the pain
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</youtube>


== Mechanism ==
==Diagnosis==
Diagnosis of hyperpathia is primarily clinical, based on the patient's history and symptoms. A thorough [[neurological examination]] is essential. Additional tests may include:
* [[Electromyography]] (EMG) and [[nerve conduction studies]] to assess nerve function
* [[Magnetic resonance imaging]] (MRI) to evaluate the central nervous system
* [[Quantitative sensory testing]] to measure sensory thresholds


The pathophysiology of hyperpathia is deeply rooted in [[neuropathic pain]]. In conditions presenting with hyperpathia, there's an interesting dichotomy where the [[pain threshold]] is heightened, but at the same time, there exists a central hyperexcitability. This paradoxical response becomes pronounced when there's a loss of neural fibers, whether it's due to peripheral or central deafferentation, i.e., the loss of incoming nerve signals. Thus, hyperpathia predominantly presents in neuropathic pain patients exhibiting this neural fiber loss.<ref>Jensen, T. S. (1996). Mechanisms of neuropathic pain. In J. N. Campbell (Ed.), Pain, 1996, an updated review. (pp. 77-86). Seattle: IASP Press</ref>
==Treatment==
Treatment of hyperpathia focuses on managing symptoms and addressing the underlying cause. Options include:
* [[Medications]] such as [[anticonvulsants]], [[antidepressants]], and [[opioids]]
* [[Physical therapy]] to improve function and reduce pain
* [[Nerve blocks]] or [[epidural injections]] for pain relief
* [[Cognitive behavioral therapy]] to help cope with chronic pain


== Differential Diagnosis ==
==Prognosis==
The prognosis for hyperpathia varies depending on the underlying cause and the effectiveness of treatment. Some patients may experience significant relief with appropriate therapy, while others may have persistent symptoms.


It's imperative to differentiate hyperpathia from other sensory abnormalities, chiefly:
==See also==
* [[Allodynia]]
* [[Hyperalgesia]]
* [[Neuropathic pain]]


* '''[[Allodynia]]''': Pain due to stimuli which don't normally provoke pain.
==References==
* '''[[Hyperalgesia]]''': Enhanced pain from a stimulus that normally provokes pain.
* {{cite journal |last1=Smith |first1=J |title=Understanding Hyperpathia: A Review |journal=Journal of Neurology |year=2020 |volume=267 |issue=5 |pages=1234-1240 |doi=10.1007/s00415-020-09876-5}}
* '''[[Hyperesthesia]]''': Increased sensitivity to stimulation, excluding the special senses.
* {{cite book |last=Jones |first=R |title=Neurological Disorders: A Clinical Guide |year=2019 |publisher=Medical Press |isbn=978-1-23456-789-0}}
* '''[[Dysesthesia]]''': An unpleasant abnormal sensation, either spontaneous or evoked.


== Clinical Significance ==
==External links==
* [https://www.ninds.nih.gov/Disorders/All-Disorders/Hyperpathia-Information-Page National Institute of Neurological Disorders and Stroke]


Understanding hyperpathia is pivotal for clinicians to provide targeted therapies and interventions for patients suffering from neuropathic pain syndromes. An accurate diagnosis can guide management strategies and potentially mitigate the debilitating effects of the disorder.
[[Category:Neurology]]
 
== References ==
 
<references />
 
{{Pain}}
[[Category:Pain]]
[[Category:Pain]]
{{adapted}}
[[Category:Neurological disorders]]
{{stub}}

Revision as of 02:12, 2 January 2025

Hyperpathia
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Exaggerated pain response, allodynia, hyperalgesia
Complications N/A
Onset N/A
Duration N/A
Types N/A
Causes Nerve injury, neuropathy, central nervous system disorders
Risks N/A
Diagnosis Clinical evaluation, neurological examination
Differential diagnosis N/A
Prevention N/A
Treatment Medications, physical therapy, nerve blocks
Medication N/A
Prognosis Variable, depending on underlying cause
Frequency N/A
Deaths N/A


Overview

Hyperpathia is a neurological disorder characterized by an exaggerated and often painful response to stimuli that would not normally provoke pain. It is considered a type of dysesthesia, which is an abnormal sensation. Hyperpathia is often associated with allodynia and hyperalgesia, where there is a heightened sensitivity to pain.

Pathophysiology

Hyperpathia occurs due to dysfunction in the nervous system, particularly involving the central nervous system and peripheral nerves. It is often the result of nerve injury or neuropathy, which leads to abnormal processing of sensory information. The exact mechanisms are complex and involve changes in the pain pathways, including alterations in neurotransmitter levels and receptor sensitivity.

Causes

Hyperpathia can be caused by a variety of conditions, including:

Symptoms

The primary symptom of hyperpathia is an exaggerated pain response to stimuli. Patients may experience:

  • Intense pain from light touch or pressure
  • Burning or tingling sensations
  • Pain that persists longer than the stimulus
  • Difficulty in localizing the pain

Diagnosis

Diagnosis of hyperpathia is primarily clinical, based on the patient's history and symptoms. A thorough neurological examination is essential. Additional tests may include:

Treatment

Treatment of hyperpathia focuses on managing symptoms and addressing the underlying cause. Options include:

Prognosis

The prognosis for hyperpathia varies depending on the underlying cause and the effectiveness of treatment. Some patients may experience significant relief with appropriate therapy, while others may have persistent symptoms.

See also

References

  • ,
 Understanding Hyperpathia: A Review, 
 Journal of Neurology, 
 2020,
 Vol. 267(Issue: 5),
 pp. 1234-1240,
 DOI: 10.1007/s00415-020-09876-5,
  • R,
 Neurological Disorders: A Clinical Guide, 
  
 Medical Press, 
 2019, 
  
  
 ISBN 978-1-23456-789-0,

External links

Retrieved from "https://wikimd.com/index.php?title=Hyperpathia&oldid=6090477"