Dysesthesia and the 6 Different Types That Occur in the Body

Definition-Introduction

Dysesthesia is a neurological symptom used as a general term to describe any type of abnormal sensation felt by an individual. It involves both painful and painless sensations, regardless of whether there is an actual stimulus triggering their appearance. Some of the most usual types of dysesthesia include burning on the skin, reduced sensitivity to pain or cold, or even finding it intolerable to wear clothing due to the discomfort caused by fabrics touching the skin. 


Types of dysesthesia found on a physical examination

It is important that patients realize that many different types of dysesthesia may be identified through a physician’s physical examination. While the list is long and may include unique sensory dysfunctions as well abnormal sensations, the most common types of dysesthesia include the following:

  • Hyperesthesia: This dysesthesia is an increase in sensitivity to superficial sensations, like pressure or touch, temperature, and pain.
  • Hypoesthesia: This is the opposite of hyperesthesia, and is decreased sensitivity to superficial sensations like temperature, pain, and pressure or touch.
  • Tactile Anesthesia: This dysesthesia is a total or almost total loss of one’s sensitivity to superficial sensation.
  • Hypoalgesia: This is sometimes called analgesia, and is a reduced perception of pain. 
  • Allodynia: This type of dysesthesia occurs when contact with a typically painless stimulus brings about extreme, often unbearable pain.
  • Hyperalgesia: This is a state of hypersensitivity to mildly disturbing stimuli.
Medically, the term hyperpathia is often used by physicians to describe dysthesesias like allodynia, hyperalgesia and any other type of hypersensitivity to usually non-painful stimuli.

A proper clinical examination

Visiting your physician is the first step toward an accurate diagnosis and successful treatment if you are experiencing sensations you consider abnormal. After taking a detailed medical history, your doctor will perform a thorough neurological exam. This will help to determine which tests may be needed to find the reason for your symptoms.

Some basic principles that patients will want to keep in mind during the exam are:

  •  Cooperation is the key to a successful neurological exam. Ask your doctor if you have questions and make sure you understand what is expected.  
  • The patient’s subjective evaluation of the symptoms is vital. The sensory test is carried out by your physician in order for you to explain the exact nature and quality of the pain. Step up and describe your symptoms in as much detail as you can. Only you know how you feel!
  • Be patient and serious. A neurological exam is one of the most interesting clinical examinations, as simple mechanical movements and puzzles may reveal important information about your condition.

Some of the tests used by physicians in the neurological exam may seem unimportant or even humorous, but they are very important, so take the exam seriously. 

The sensory neurological examination involves assessing the quality of the following senses:

  • Pain
  • Temperature-cold
  • Temperature-hot
  • Touch
  • Vibration

Since the exam involves these senses, in order to evaluate them, you may be asked to place your hands in a bowl of hot or cold water in order to assess the level at which you can feel the temperature. You may also be asked whether you can feel the touch of a cotton pad on certain areas of the skin, both where you have been experiencing symptoms, as well as on problem-free areas. The sensitivity in problematic areas may then be compared to areas of the body where you are not having symptoms. Other sensory tests may also be performed. 

What are possible causes of dysesthetic symptoms?

There are many possible conditions leading to the experience of abnormal sensations. When the clinical examination reveals no serious disease, it can be quite challenging to determine their cause. Some possible reasons why a person is experiencing dysesthesias, even while having normal sensory tests, include conditions like myelopathy or vitamin B12 deficiency.

Dysesthesias that relate to an area innervated by a set of specific nerves can be a result of nerve damage. Conditions that can result in peripheral or central nerve damage that may lead to dysthesesias include:

Peripheral Polyneuropathies:

  1. Guillain-Barre syndrome
  2. Charcot-Marie-Tooth Disease
  3. Diabetic peripheral polyneuropathy
  4. Toxic polyneuropathies
  5. Sjogren’s syndrome 
  6. Peripheral nerve compression due to other causes (hematomas in adjacent tissues, hernias, etc.)

Spinal Conditions:

  1. Brown-Seguard syndrome, due to damage to one-half of the spinal cord
  2. Radiation therapy to the spinal region
  3. Various types of spinal trauma
  4. Syringomyelia
  5. Multiple Sclerosis

Thalamic causes

           Small strokes in the region of the thalamus, the area of the brain controlling sensory perception, can cause dysesthesias. The thalamic syndrome or Dejerine-Roussy Syndrome is a condition in which the stroke actually leads to a state of permanent, agonizing pain brought about any stimuli.

Epileptic Seizures

The duration of seizures varies, and they may be accompanied by involuntary movements and loss of consciousness.

Diagnosis and Treatment

Given the variety of conditions leading to the abnormal perception of stimuli, there is no specific test capable of diagnosing each and every one of them. The clinical examination, and the location of the sensation and its other characteristics, helps the physician decide which tests will be needed in order to proceed to a diagnosis. Depending on the cause of the symptoms and the underlying disease, if present, proper treatment will be administered.