About thalamic hyperesthetic anesthesia

What is thalamic hyperesthetic anesthesia?

Central pain syndrome is a neurological disorder caused by damage to the central nervous system (CNS). Common symptoms include pain and loss of sensation, usually in the face, arms and/or legs. Pain is often constant and can be mild, moderate, or severe in intensity. Affected individuals may become hypersensitive to painful stimuli. The specific type of pain experience can vary from one individual to another based, in part, upon the underlying cause of the disorder and the area of the central nervous system affected. Central pain syndrome can potentially disrupt an individual's daily routine. In severe cases, the pain can be agonizing and unrelenting and dramatically affect a person's quality of life. Central pain syndrome can develop following a variety of conditions including stroke, multiple sclerosis, spinal cord injury, or brain tumors.

For years, it was believed that the majority of cases of central pain syndrome were due to damage of the thalamus most often caused by a stroke. The disorder was frequently referred to as thalamic pain syndrome or Dejerine-Roussy syndrome after two French neurologists who reported on the disorder in the early 1900s. In fact, to some degree central pain became synonymous with thalamic pain syndrome for many years. However, researchers now know that damage to other areas of the CNS can cause central pain syndrome, including cases following a stroke. Consequently, the preferred name for this group of disorders is central pain syndrome to acknowledge that damage to various areas of the CNS (and not predominantly the thalamus) can cause central pain and that a stroke is not necessarily the primary cause. The preferred term for the specific subtype of central pain syndrome caused by CNS damage due to a stroke is central post-stroke pain.

What are the symptoms for thalamic hyperesthetic anesthesia?

The symptoms of hyperesthesia vary between people. They depend on which senses are affected and how severely:

  • Some people with touch sensitivity can experience severe Pain when a stimulus triggers their nerves.
  • People with auditory sensitivity can hear painfully loud noises when none have occurred in the environment.
  • Those with smell sensitivity often report a wide range of smells without the presence of a stimulus.

Some people will experience a combination of these symptoms. Severe hyperesthesia can also affect the nervous system, which might lead to nerve Inflammation and seizures.

What are the causes for thalamic hyperesthetic anesthesia?

Neuropathic pain is a common underlying cause of hyperesthesia, but many diseases or lesions of the nervous system can lead to this type of pain.

Associated health conditions and stimuli include (but are not limited to):

  • systemic diseases like diabetes, nutritional deficiencies, and hypothyroidism
  • infectious diseases, such as HIV, herpes, hepatitis C, and varicella
  • toxic causes, including alcohol, certain chemotherapy drugs, and immunosuppressants
  • mechanical causes, such as physical trauma, complex regional pain syndrome, nerve root compression, and phantom limb pain after an amputation
  • hereditary causes like Charcot-Marie-Tooth disease

What are the treatments for thalamic hyperesthetic anesthesia?

The treatment for hyperesthesia centers around addressing the underlying cause. If you experience hyperesthesia due to diabetic neuropathy, keeping your blood glucose under control can help keep the problem from getting worse.

If a vitamin B12 deficiency is causing the hyperesthesia, a physician might prescribe B12 supplements. After treating the underlying condition or removing the triggering stimulus, most people will find that the symptoms of hyperesthesia resolve.

If there’s an underlying problem in the brain or spinal cord, your doctor will assess and treat this accordingly.

Managing the effects of episodes

Some conditions linked to neuropathy, like diabetes, are chronic. It’s important to find methods of reducing the physical and emotional sensations around hypersensitivity.

What you can do

It’s important to remember that the condition is usually manageable. Making certain lifestyle changes can ease your symptoms considerably. You may want to try to:

  • Reduce your caffeine and alcohol intake, or eliminate them completely.
  • Eat a well-balanced, nutritious diet.
  • Train yourself to stay calm during flares of hypersensitivity by regularly practicing yoga or meditation.

What your doctor can do

Some medical interventions might also help, including:

  • Physical therapy. This can help people who experience increased pain as a result of their hyperesthesia regain mobility and improve their quality of life.
  • Cognitive behavioral therapy (CBT). CBT can be effective in reducing the unpleasant responses caused by any stimulus.
  • Antiepileptic drugs, including gabapentinoids. People experiencing seizures can take anticonvulsant medications to reduce the frequency and severity of their seizures. These medications can also help reduce hyperesthesia pain in people who don’t experience seizures.
  • Anxiolytic medications. People can take anxiety-reducing medication if they are experiencing fear and anxiety around their condition. Hyperesthesia can be debilitating and affect your ability to be around the many stimuli of daily life. This can have a negative effect on your mental health.
  • Antidepressant medications. Antidepressants can help reduce neuropathic pain as well as depression.

A 2020 review suggests a diet with plenty of flavonoids might help people reduce the effects of neuropathy. Flavonoids are compounds in plants that provide antioxidants, which help counter the harmful effects of damaging free radical molecules around your body.

However, the review largely used studies that tested the effects of flavonoids in a lab and on animals, rather than in humans. The review also focused only on peripheral neuropathy, but other types like central neuropathy might work differently.

So, it’s difficult to say that the findings can carry over to humans or all types of neuropathy, but they are promising.

What are the risk factors for thalamic hyperesthetic anesthesia?

Children with autism, obsessive-compulsive disorder (OCD), and attention deficit hyperactivity disorder (ADHD) are more likely to develop hyperesthesia.

Many people in menopause also report a particular type of hyperesthesia called formication, in which they experience sensations on the skin such as tingling, crawling, or itching.

Is there a cure/medications for thalamic hyperesthetic anesthesia?

Your outlook for hyperesthesia will depend on the underlying cause. Supplementing a B12 deficiency can clear up hyperesthesia symptoms entirely. For neurodiverse people, managing overstimulation will likely be a lifelong health goal.

Hyperesthesia can be unsettling and may cause pain, fear, and anxiety in those who live with it.

Hyperesthesia can exist on its own or as a symptom of another related health condition. Whichever applies to you, your doctors will try to diagnose the root cause so it can be treated effectively.

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