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Congenital insensitivity to pain is a rare illness that can cause accidental external and internal injuries in children. When child abuse is suspected, the awareness of this illness can complicate any medicolegal interpretation of findings.Several components are needed to diagnose congenital insensitivity to pain: lack of sensitivity to pain since birth; involvement of the whole body; integrity of osteotendinous reflexes; and other sensitivity processes and negative paraclinical, including histological, examinations.This article describes the case of two siblings examined during an emergency legal procedure at the forensic medicine unit of the Grenobles University Hospital Centre in France. The medico-legal interpretation of facts and examinations must be conservative in case of legal complications and must follow an analysis of the child's and family's medicosocial problems since the child's birth. The family's socioeducational support and the communication of information on this illness should be a priority to avoid any misunderstanding and overrun in the child's management and monitoring.
Escard
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Médecin légiste, assistant des hôpitaux, département d'anthropologie, Université Laval, Québec. zencamus@aol.com
Barret
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