[Chronic right-sided pain-associated nondermatomal somatosensory deficit following an accident].
We present the case of a 48-year old man who, eight years after an industrial accident, presents with chronic right-sided nondermatomal pain and hypaesthesia to heat and touch. During symmetric peripheral touch functional magnetic resonance imaging revealed hypometabolism in the left thalamus, somatosensory cortex, and anterior cingulate cortex. Pain-associated nondermatomal somatosensory deficits (NDSDs) localizing to one side of the body are a frequent clinical entity, which are often triggered by an accident. The tendency of NDSDs to extend to adjunct ipsilateral body parts and to become chronic points to maladaptive adjustment of pain-processing areas in the central nervous system. Psychological stress prior to or around the triggering event seems an important risk factor for NDSDs.
Egloff
Niklaus
N
Kompetenzbereich für Psychosomatische Medizin, Universitätsklinik für Allgemeine Innere Medizin, Inselspital, Universitätsspital Bern. niklaus.egloff@insel.ch
Gander
M-L
ML
Gerber
S
S
von Känel
R
R
Wiest
R
R
D000062:Accidents, Occupational / Q000523:psychology; D000328:Adult; D001921:Brain / Q000503:physiopathology; D001930:Brain Injuries / Q000175:diagnosis* / Q000523:psychology; D002574:Cervical Vertebrae / Q000293:injuries*; D020918:Complex Regional Pain Syndromes / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D004292:Dominance, Cerebral / Q000502:physiology*; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis* / Q000523:psychology; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D010100:Oxygen / Q000097:blood; D010468:Perceptual Disorders / Q000175:diagnosis / Q000523:psychology; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000523:psychology; D013124:Spinal Injuries / Q000175:diagnosis* / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications
D010100:Oxygen