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Hyperpathia is a clinical symptom of certain neurological disorders wherein nociceptive stimuli evoke exaggerated levels of pain. This should not be confused with allodynia, where normally non-painful stimuli evoke pain.

Mechanism

Hyperpathia describes the neuropathic pain which the pain threshold on one hand is elevated and the other hand is central hyperexcited whenever there is a loss of fibres. Hyperpathia is underlying the peripheral or central deafferentation when the afferent inputs are lost.^[1] Hyperpathia only occurs on neuropathic pain patients with the loss of fibres.

The International Association of the Study of Pain’s (IASP) definition of hyperpathia is that: A painful syndrome characterized by an abnormally painful reaction to a stimulus, especially a repetitive stimulus, as well as an increased threshold. The definition also complies with a note which is: It may occur with allodynia, hyperesthesia, hyperalgesia, or dysesthesia. Faulty identification and localization of the stimulus, delay, radiating sensation, and after-sensation may be present, and the pain is often explosive in character. The changes in this note are the specification of allodynia and the inclusion of hyperalgesia explicitly. Previously hyperalgesia was implied, since hyperesthesia was mentioned in the previous note and hyperalgesia is a special case of hyperesthesia.^[2]

References

^ Jensen, T. S. (1996). Mechanisms of neuropathic pain. In J. N. Campbell (Ed.), Pain, 1996, an updated review. (pp. 77-86). Seattle: IASP Press
^ (I.A.S.P, 1986). Pain Supplement 3: Classification of Chronic Pain, Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms. Amsterdam: Elsevier.

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1. 中枢神経障害顔面痛 central neuropathic facial pain
2. 感覚消失患者へのアプローチ approach to the patient with sensory loss

English Journal

N-methyl-D-aspartate receptors involved in morphine-induced hyperalgesia in sensitized mice.

Ahmadi S1, Golbaghi H2, Azizbeigi R3, Esmailzadeh N4.
European journal of pharmacology.Eur J Pharmacol.2014 Aug 15;737:85-90. doi: 10.1016/j.ejphar.2014.04.048. Epub 2014 May 16.
The aim of this study was to investigate role of the N-Methyl-D-Aspartate (NMDA) receptors in the decrease of morphine analgesia in mice after nociceptive sensitization. We used a hot plate test to assess effects of morphine on pain behavior in male NMRI mice. All drugs were administered through an
PMID 24842190

Citral: A monoterpene with prophylactic and therapeutic anti-nociceptive effects in experimental models of acute and chronic pain.

Nishijima CM1, Ganev EG2, Mazzardo-Martins L3, Martins DF4, Rocha LR5, Santos AR6, Hiruma-Lima CA7.
European journal of pharmacology.Eur J Pharmacol.2014 Aug 5;736:16-25. doi: 10.1016/j.ejphar.2014.04.029. Epub 2014 Apr 30.
Citral (3,7-dimethyl-2,6-octadienal) is an open-chain monoterpenoid present in the essential oils of several medicinal plants. The aim of this work was to evaluate the effects of orally administered citral in experimental models of acute and chronic nociception, inflammation, and gastric ulcers caus
PMID 24792822

Chronic administration of modafinil induces hyperalgesia in mice: Reversal by l-NG-nitro-arginine methyl ester and 7-nitroindazole.

Gupta R1, Gupta LK2, Bhattacharya SK1.
European journal of pharmacology.Eur J Pharmacol.2014 Aug 5;736:95-100. doi: 10.1016/j.ejphar.2014.04.035. Epub 2014 May 2.
Modafinil [2-((diphenylmethyl) sulfinyl) acetamide] is a central nervous system stimulant. It has received considerable attention as a potential psychotropic agent in several psychiatric disorders. The current study was carried out to investigate the effect of modafinil after acute administration on
PMID 24791680

Japanese Journal

頸部術後に CRPS (Complex Regional Pain Syndrome) tupe I を生じた1例

耳鼻咽喉科臨床 103(1), 65-69, 2010-01-01
NAID 10026216431

Hyperesthesia : An Early Manifestation of Diabetic Polyneuropathy

Internal medicine 41(12), 1079-1080, 2002-12-01
NAID 10010581873

交通外傷後に上肢CRPS type I を呈した外傷性頸部症候群の1例

日本ペインクリニック学会誌 8(2), 103-106, 2001
NAID 130004239247

Related Pictures

★リンクテーブル★

リンク元

「疼痛」

　　[★]

英: pain, dolor
同: 痛み
関: 痛覚 pain sensation

疼痛

疼痛の伝達

Aδ線維
C線維

疼痛の調節

ゲートコントロール：Aδ線維とC線維による痛みはAβ線維による入力で中枢伝達細胞のレベルで抑制される。
下行性疼痛抑制系神経系：下行性疼痛抑制系神経系による入力で中枢伝達細胞のレベルで抑制される。

下行性疼痛抑制系神経系は中脳水道周辺灰白質からの脊髄への入力からなる。具体的には大縫線核(セロトニン作動性)、巨大細胞網様核・傍巨大細胞網様核(ノルアドレナリン作動性)がの2系統が起点となる。抗うつ薬はこれらの神経伝達物質の再吸収を妨げ鎮痛作用を発揮する。

痛みと異常知覚の命名法

Adams and s Principles of Neurology, Ninth Edition Allan Ropper. table 8-2より抜粋

dysesthesia : Any abnormal sensation described as unpleasant by the patient.
hyperalgesia : Exaggerated pain response from a normally painful stimulus; usually includes aspects of summation with repeated stimulus of constant intensity and aftersensation.
hyperpathia : Abnormally painful and exaggerated reaction to a painful stimulus; related to hyperalgesia.
hyperesthesia (hypesthesia) : Exaggerated perception of touch stimulus.
allodynia : Abnormal perception of pain from a normally nonpainful mechanical or thermal stimulus; usually has elements of delay in perception and of aftersensation.
hypoalgesia (hypalgesia) : Decreased sensitivity and raised threshoid to painful stimuli.
anesthesia : Reduced perception of all sensation, mainly touch.
pallanesthesia : Loss of perception of vibration.
analgesia : Reduced perception of pain stimulus.
paresthesia : Mainly spontaneous abnormal sensation that is not unpleasant; usually described as "pins and needles".
causalgia : Buming pain in the distribution of one or more peripheral nerves.

[1] Jensen, T. S. (1996). Mechanisms of neuropathic pain. In J. N. Campbell (Ed.), Pain, 1996, an updated review. (pp. 77-86). Seattle: IASP Press

[2] (I.A.S.P, 1986). Pain Supplement 3: Classification of Chronic Pain, Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms. Amsterdam: Elsevier.

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hyperpathia