Article
Publicly Available
Hyperexcitable C-nociceptors in human paroxysmal pain
-
I.P. Kleggetveit
Published/Copyright:
July 1, 2010
Objectives
Spontaneously occurring paroxysmal pain is an important constituent of the symptomatology of neuropathic pain. While mechanisms of stimulus-evoked pain and also spontaneous ongoing pain have been studied for a long time, little emphasis has been put on the mechanisms of paroxysmal pain. The objective of the present study was to record from single C-nociceptive fibres in a patient presenting with pure paroxysmal pain.
Methods
A woman diagnosed with Ehler-Danlos syndrome was investigated clinically in two separate sessions with 1–2 years apart as well as with EMG/neurography, QST (assessment of thermal thresholds), QSART (quantitative sudomotor axon reflex test) and microneurography.
Results
At the time of the first investigation, the patient reported only spontaneous paroxysmal pain of high intensity several times daily, appearing all over the body. One–two years later the paroxysmal pain was unaltered, but she had during the last months developed an ongoing pain in the feet. On both occasions EMG/neurography and QSART were normal, whereas thermal thresholds on the dorsum of the feet were highly elevated. Microneurography from 29 C-nociceptive fibres showed a high amount of fibres with signs of hyperexcitability (spontaneous activity and sensitisation for mechanical stimulation).
Conclusion
Although the relationship between spontaneous paroxysmal pain, spontaneous ongoing pain and hyperexcitable peripheral C-nociceptors are unclear, the findings in this patient could represent an interesting contribution to the understanding of mechanisms underlying spontaneous paroxysmal pain.
Published Online: 2010-07-01
Published in Print: 2010-07-01
© 2010 Scandinavian Association for the Study of Pain
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