A case of 'pure' dynamic mechano-allodynia due to a lesion of the spinal cord: pathophysiological considerations.
We report the unusual observation of a patient who presented with the single symptom of a very intense, brush-induced allodynia (dynamic mechanical allodynia) which was strictly confined to the left C2 and C3 dermatomes. All investigations, including a cervical spinal MRI, were initially normal. The clinical picture remained stable for several months until the appearance of spontaneous pain and sensory deficits suggestive of a spinal lesion. A second MRI revealed an intraspinal lesion involving the C2-C5 segments. In accordance with other clinical and animal studies, such an observation of a 'pure' dynamic mechano-allodynia suggests that specific mechanisms underlie each component of neuropathic pain. Possible pathophysiological mechanisms are discussed in the light of recent experimental results obtained in animals.
Attal
N
N
Unité d'Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, Boulogne, France.
Brasseur
L
L
Chauvin
M
M
Bouhassira
D
D
D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006941:Hyperesthesia / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D009333:Neck; D010812:Physical Stimulation; D013118:Spinal Cord Diseases / Q000150:complications* / Q000175:diagnosis
D000700:Analgesics