What is Dysesthesia
Dysesthesia is a noun that derives from the Greek words "dis", which means "abnormal" and "aesthesis", which means "sensation"; the meaning of dysesthesia is "abnormal sensation".
Dysesthesia is caused by lesions affecting the nervous system, both peripheral and central. The various forms of dysesthesia can affect the tissues of any part of the body, including the most frequent that of the mouth, scalp, skin and legs.
In some cases, it has been described as a sensation of subcutaneous acid. This dysaesthetic burning could specifically reflect a state of acidosis of the synapses and the perineural space. Not surprisingly, in the presence of some nerve lesions, with the lowering of the pH, certain ion channels tend to open. The spontaneous discharge of pain receptors has also been implicated as a potential cause of dysesthesia.
Patients with dysesthesia may become unable to feel pain without any apparent damage to the skin or tissues. Some suffer from psychological disorders.
Living with Dysesthesia
A patient suffering from dysesthesia may have to endure a very painful condition.
The suffering imparted by burning dysesthesia is defined as "Dante's", referring to the description by the author in the "Divine Comedy" (classical literature).
Changes in temperature and heat, as well as rubbing, contact with rough surfaces or even just the touch of the skin, affect nervous perception and increase the level of pain.
Often, the patient is unable to bear even the touch of clothing. Life focuses on trying to avoid or reduce the perception of pain. One of the greatest difficulties is that of rest and sleep, due to contact between clothing or sheets on the skin.
Sometimes, patients are led into a hysterical search for pain relief, often ending in resignation and depressive symptoms.
Forms of chronic anxiety and tingling of the face are frequently associated with dysesthesia. In one specific study, the patients examined had in common: anxiety symptoms, depression, obsessive-compulsive personality disorders or somatoform disorders.
Is there a cure?
Both oral physical muscle therapy and pharmacological therapy with antidepressants are effective treatments for occlusal dysesthesia. To be absolutely avoided, the rectification or replacement or removal of pre-existing dental work, despite the perception of urgent need.
Antidepressants are also sometimes prescribed in cases of dysesthesia affecting the scalp.
A study found that many patients with "Burning Mouth Syndrome" (BMS), or the so-called "burning mouth syndrome" (a variant of occlusal dysesthesia) report painful sensations in other parts of the body. Some show a comorbidity with "Restless Leg Syndrome" (RLS), or "restless legs syndrome", and 50% said they have at least one case in their family. The findings suggest that some symptoms of BMS may be caused by the same nerve pathway as RLS, indicating that dopaminergic drugs routinely used to treat RLS may be equally effective.
Types
Dysesthesia can be described as a class of neurological disorders and classified according to the body district or the type of sensation evoked.
Skin dysesthesia is characterized by discomfort or pain from contact with the skin in the presence of normal stimuli, such as those in wearing clothes. The unpleasantness can range from a mild tingling to a disabling pain.
Scalp dysesthesia is characterized by pain or burning sensations below the skin surface of the skull. It can also manifest itself as excessive itching.
Occlusal dysesthesia, or "phantom bite", is characterized by the sensation that the action of the bite leads out of the expected place (occlusal dystopia), despite the absence of compromises of the dental and maxillofacial structures or tissues. Ghost bite often occurs in patients who have undergone dental procedures; at the moment, no therapeutic treatment systems are known.
Causes
Dysesthesia can be caused by:
- Diabetes, in which it can be relieved using creams containing capsaicin (the active ingredient in chilli)
- Guillain-Barré syndrome, a form of acute polyneuritis radicle that manifests with progressive disto-proximal paralysis
- Neuropathy, a combination of paraesthesia, gait disturbances, weakness and absence of tendon reflexes
- Lyme disease in which, together with polyneuropathy, it represents a symptom of infectious nerve damage from bacteria of the genus Barrelia. The dysaesthetic sensations persist even after antibiotic treatment
- Withdrawal from alcohol or other drugs, in case of addiction
- Multiple sclerosis, which effect of spinal cord injuries
- Oral surgery, in occlusal dysesthesia
- GM2 gangliosidosis or variant B of Tay-Sachs disease, due to the deficiency of the enzyme hexoamine oxidase A and accumulation of gangliosides
- Peripheral neuropathy of the hands, feet and sometimes of the arms and legs, induced by chemotherapy
- Stroke involving the nuclei of the posterolateral ventral thalamus, especially in the Dejerine-Roussy syndrome.
Recognize it
Most individuals with dysesthesia or phantom limb syndrome (SAF) also complains of a sensation of pain. However, the two conditions must not be confused.
In SAF, there is the sensation of having an amputated or absent limb, while the dysaesthetic person reports discomfort or pain for a tissue that has not been removed or amputated, therefore completely intact. Furthermore, the tissue may not be that of a limb, but of another part of the body, such as the abdomen.
Sometimes, dysesthesia can occur concomitantly with the phantom limb syndrome in paralyzed individuals or individuals born without limbs. from damage to the nerves themselves.
Dysesthesia should also not be confused with anesthesia, hyperesthesia and paresthesia, which refer to a loss, excess or distortion of sensitivity. It is a very distinct picture, since it refers to spontaneous sensations manifested in the absence of stimuli. For example, in the case of a dysaesthetic sensation evoked by the touch of clothing, this will be characterized by irrelevance (eg burning) and not by excess, defect or tactile distortion.
Last news
Many hypotheses have been advanced about the pathological nature of occlusal dysesthesia.
Some researchers believe that this disorder is exclusively psychological in nature, while others argue that it is psychosomatic.
Others hypothesize that occlusal dysesthesia is rooted in some pathological psychiatric pictures and suggest that it can occur, following dental treatment, in patients with psychological disorders (such as schizophrenia).
Two studies have shown that occlusal dysesthesia is associated with somatoform disorders in which patients are obsessed with sensations in the oral cavity.
The hypothesis has been advanced that occlusal dysesthesia may be caused by the brain in the mechanism of "internal dialogue", which would cause abnormal oral sensations in the absence of external stimuli. According to this theory, the symptoms of dysesthesia are catalyzed by amputation, for example the extraction of a tooth, due to which the brain loses the ability to distinguish memory between the old and the new movement.
Finally, it has been suggested that occlusive dysesthesia may be caused by a false signal sent from the peripheral nervous system to the central nervous system. However, there is no method for determining nerve sensory thresholds and perception is often measured with a thickness called "Interdental Thickness Discrimination" (ITD), or with the ability to distinguish between the size of objects (small blocks) placed between the teeth. . In one study, patients with occlusal dysesthesia showed a greater ability to differentiate these control objects than healthy individuals, although the differences were not statistically significant.
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