Insensitivity to pain

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Insensitivity to pain (also analgesia from ancient Greek ἄλγος álgos 'pain', with negative alpha privativum : 'no pain') is brought about in medicine by switching off the sensation of pain or is a pathological absence of pain . Pain is switched off in the sense of pain therapy by reducing or interrupting the conduction of excitation or by administering drugs ( analgesics and sedatives ), together in analgesic sedation . The term analgesia is sometimes used synonymously with anesthesia . While with this, however, all sensations are switched off, for example, the touch sensitivity remains under analgesia.

Pain therapy

Pain can be eliminated by pharmacological, anesthesiological or physical methods. Pharmacologically different are analgesics , especially non-steroidal anti-inflammatory drugs as a NSAID (- English n on- s teroidal a NTI i nflammatory d rugs ) designated - and analgesics of the morphine type ( opioids used). Anesthesia procedures are used for acute pain therapy within a limited period of time and can be carried out as general or local anesthesia . Physical exercises include physiotherapy, movement therapy and massage . By electrical stimulation or acupuncture to pain can be reduced.

The Psychotherapy can lead to a significant reduction in pain in some cases. Analgesia can also be brought about through hypnosis , suggestion , and autogenic training (e.g. during a dental operation or during childbirth).

In extreme cases, neurosurgical treatment can sever the nerves and end the pain.

Forms of analgesia with disease value

In addition to medically induced analgesia, there are also pathological forms of insensitivity to pain. They can be caused by injuries (nerve injuries, paraplegia ) as well as by a congenital defect.

Congenital analgesia

Mutations at SCN9A - gene , which has a sodium channel coding can lead to congenital complete insensitivity to pain with clinical significance. About 30 affected people have been known to date. With this innate insensitivity to pain, those affected often inflict severe damage to themselves from birth, as the warning effect of the pain is no longer applicable.

A mutation in the SCN11A gene also leads to an innate, complete freedom from pain, as this mutation leads to an overfunction of a sodium channel in the shell of nerve cells located in the spinal cord and thus at the switching point for the transmission of pain signals to the brain. Contrary to the expectations of the scientists, the overfunction of the canal does not lead to an increased pain perception, but to an overload of the affected cells, which for this reason can no longer regenerate and are consequently paralyzed in their function.

CIPA syndrome

Another cause of analgesia with disease value can also be the CIPA syndrome , which is not only a disruption of the sense of pain but also of the temperature, as well as anhidrosis , as well as a lack of sweat secretion .

Individual evidence

  1. Arnd Krüger : History of movement therapy. In: Preventive Medicine . Springer, Heidelberg Loseblatt Collection 1999, 07.06, pp. 1–22.
  2. JP Drenth, SG Waxman: Mutations in sodium-channel gene SCN9A cause a spectrum of human genetic pain disorders . In: J. Clin. Invest. . Vol. 117, No. 12, December 2007, pp. 3603-3609. PMID 18060017 . PMC 2096434 (free full text).
  3. Vivienne Baillie Gerritsen: Silent pain. In: Protein Spotlight. February 2009, No. 102, ISSN  1424-4721 .
  4. Enrico Leipold, Lutz Liebmann a. a .: A de novo gain-of-function mutation in SCN11A causes loss of pain perception. In: Nature Genetics. 45, 2013, p. 1399, doi : 10.1038 / ng.2767 .
  5. JJ Cox, F. Reimann, AK Nicholas et al .: An SCN9A channelopathy causes congenital inability to experience pain . In: Nature . Vol. 444, No. 7121, December 2006, pp. 894-898. doi : 10.1038 / nature05413 . PMID 17167479 .