Hyperesthesia – Understanding and Living with it

Introduction

Among the multitude of diseases in today’s world, Hyperesthesia is one of them. It is an ailment identified by sharp sensitivity to different stimuli. It affects a person’s five senses of sight, hearing, touch, smell, and taste. Individuals affected by hyperesthesia are mostly restless due to the heightened senses and increased awareness.  Here, the central nervous system undergoes excess stimulation wherein people exhibit a myriad of symptoms like nausea, dizziness, lack of sleep, headache, confusion, disorientation, restlessness, and other brain disorders.

Hyperesthesia - Types, Causes, Symptoms, Risk Factor, Diagnosis, Treatment.

In psychology, this malady is described as people with gifts and talents as in their case the sensory information reaches the brain much faster than the average human being and the ensuing information is set in motion in a radically shorter spell.

However, it is always a good idea to make an appointment with a neurologist when you find yourself experiencing symptoms of hyperesthesia as it is treatable.

Animals are not excluded from this disease and dogs and cats of all ages suffer from hyperesthesia. Veterinary neuroscientists continue to study the diagnosis and treatments for many feline afflictions associated with the brain, though some situations remain ambiguous.

What is Hyperesthesia?

Hyperesthesia is classified as the sharp sensitivity to different responses of the senses. It means a person who suffers from this condition is conscious of an added sensation and reaction in terms of the things they see, the food they taste, the sounds they hear, surfaces they touch, fragrances and smells they encounter, etc.  Folks with hyperesthesia may face sensations without any reason and sometimes the stimuli may also become intolerable.

Though not well defined, the source of Hyperesthesia is generally linked to the nervous system and hence, classified as a neuropathic pain, angiostrongyliasis, leptomeningitis, chemical poisoning, Parsonage-Turner syndrome, and meningitis that generally lead to brain dysfunctions and more often than not, to a brain tumor.

It concerns the peripheral nervous system and alters the signals running between the brain and the remainder of the body. Sometimes the state may be prompted by excessive activity in the area of that part of the brain concerned with sensation and in such cases; the problem may settle within a short span.

Hyperesthesia can sometimes be quite serious, but when detected early, the treatment prospects can improve significantly.

Types of hyperesthesia

Tactile hyperesthesia:

Increased sensitivity to touch is called tactile hyperesthesia or tactile sensitivity. This condition could occur in fragile X syndrome, cases of autism, and ADHD. As per studies carried out at the Hebrew University, almost 69 percent of males suffer from tactile hyperesthesia. It is normally presented as an indicator of disorders of the nervous system such as peripheral neuropathy, radiculopathies, and herpes infections. When the particular neurologic disorder is taken care of, hyperesthesia is concurrently cured.

A trained occupational therapist is most often engaged to treat Tactile Hyperesthesia in children. The child is guided through prearranged, fun-filled activities that confront the child’s ability to feel. Tactile sensitivity is linked with viral infections such as skin rashes and eruptions. Young people with a history of autism, ADHD disorder, or fragile X syndrome can cultivate tactile sensitivity later on.

Visual hyperesthesia:

Increased sensitivity of vision is called visual hyperesthesia. Due to head injuries, the ability to tolerate extreme light and sound stimuli is considerably reduced in patients with Visual Hyperesthesia.  Studies relate to two levels of behavior-

(1) With cognitive or post-concussive complaints

(2) With vegetative or emotional complaints revealed that visual hyperesthesia was explicitly related to cognitive or post-concussive complaints.

Certain types of visual dysfunctions are noticed following MTBI (Mild Traumatic Brain Injury) such as accommodative insufficiency, convergence, and oculomotor divergence. These patients with MTBI also suffer from near point of convergence, stereo acuity, refractive status, and functions that are associated with vision. Therefore, such disorders are an impediment for the sufferer for carrying out their daily tasks that require visual awareness such as reading and concentration.  Photophobia or light sensitivity is another common visual complaint.

Direct or indirect injury to the eye is another area requiring attention as retinal injury may take place in the form of retinal hemorrhage or detachment.

Auditory hyperesthesia:

Increased sensitivity to hearing is called auditory hyperesthesia or auditory sensitivity. This condition is categorized by an unusual intensity in hearing because of the irritation caused due to auditory stimuli where normal sound levels become intolerable.

Tinnitus is one such symptom of Auditory Hyperesthesia where there is a constant humming, buzzing, or whistling sound in either one ear or both and sometimes in the head. This noise is from within the body rather than outside.  Often the sound has a rhythm in accordance to the person’s pulse and it is known as pulsatile tinnitus. It is most audible when you are tired or trying to sleep and can even lead to Insomnia and depression in due course.

Temporary tinnitus can be caused by prolonged exposure to loud music, a cold, or knock on the head and it can be experienced at any age. A cure for Tinnitus has not yet been found. However, treatments like relaxation therapy, cognitive behavioral therapy (CBT) and sound therapy do help such people.

Causes of Hyperesthesia

Hyperesthesia cannot be attributed to a single cause.  There are numerous reasons for this health condition. Sometimes, it could be triggered by outside forces while at other times it may not. Mostly, it is due to overstimulation of the central nervous system. However, if internal sources are responsible for the excessive stimulation of the brain and it is not due to outside stimuli, then Hyperesthesia can last just a few hours. Various diagnostic tests, however, need to be carried out to confirm the specific cause. Related symptoms such as headache, dizziness, disorientation, and confusion are also identifiable.

Apart from the above, some of the observed causes could be:

  • Caffeine can temporarily induce this condition in humans when taken in excess due to the extreme stimulation of the cortex, spinal cord, and medulla that form a part the central nervous system. However, the symptoms stop after about 3 – 5 hours.
  • In some cases, it is triggered by overstimulation of the area of the brain involved in sensation, in which case the hyperesthesia should resolve within a few hours.
  • Indulging in excess alcohol consumption or coffee intake can provoke over-reaction of the nervous system, in particular the cortex and cerebrum area of the brain. The increased stimulation of the cerebrum can give rise to increased activity for a short while.
  • Expert observation points to ADHD (Attention Deficit Hyperactivity Disorder) among children suffering from hyperesthesia. According to them, the mental state in young children can activate a tangible feeling, making them extra sensitive to touch.
  • Sometimes it could also be autism-related. Autism generally occurs in young children. Here, though hyperesthesia is not really the main culprit, it is an indicator of autism characterized by the inability to communicate, necessary adjusting attitude and unsociability. A genetic disorder known as Fragile X syndrome can also lead to autism.
  • Diabetes or injury-induced neuropathy is marginal and may sometimes produce tactile hyperesthesia.
  • Prolonged exposure to loud noise, injuries to the head or ear, Meniere’s disease, temporomandibular joint (TMJ) syndrome, Superior Canal Dehiscence Syndrome (SCDS) or Lyme disease can also trigger auditory Hyperesthesia. Studies reveal most patients with Lyme disease have a sharp sense of smell.

Different Symptoms of Hyperesthesia

Some of the common symptoms are – insomnia, restlessness, disorientation, confusion, dizziness, vomiting tendency, and headache. Hyperesthesia symptoms differ from person to person as it is dependent on the severity of the affected sense.

For instance-

  • People with sensitivity to touch can undergo harsh pain when their nerves are activated.
  • People suffering from a hypersensitive sense of hearing can hear agonizingly earsplitting noises when actually no such noise is present.
  • People with smell stimuli experience a varied assortment of smells and fragrances when in actual fact nothing relating to any specific smell is present.
  • Some people undergo a mixture of these signs.
  • In critical cases, hyperesthesia not only affects the nervous system, but can also lead to a soreness of the nerves, thus producing seizures.

Risk Factors of Hyperesthesia

  1. There is no solitary cause for Hyperesthesia and it can occur due to a variety of conditions, one being peripheral stimuli.
  2. Consuming too much alcohol or beverages like coffee can cause short-term hyperesthesia due to excess stimulation of the nervous system.
  3. People experiencing an outbreak of skin eruptions or itchiness may also be suffering from tactile sensation. This is usually viral which sorts itself out in a few days.
  4. Increased sensory responses are experienced when the nerves are moderately or entirely damaged which normally occur due to injury or when nerves are compressed.
  5. Individuals suffering from a deficiency of vitamin B-12 are prone to attacks of hyperesthesia.
  6. Children with fragile X syndrome, autism, and attention deficit hyperactivity disorder generally develop hyperesthesia.

Ways to Diagnose Hyperesthesia

As of now, no tangible experiment or analysis has been able devised to establish the presence of hyperesthesia. However, some of the following steps could be taken to diagnose hyperesthesia.

  • Upon noting your symptoms, the doctor can suggest appropriate tests to recognize the root of the pain and discomfort.
  • The general practitioner will also like to know if you are a regular hard drinker and your measure of consumption.
  • Blood culture is recommended for gauging the blood sugar level as well as vitamins.
  • For evaluating the origin of the problem in the brain, Imaging tests like MRI scan and X-rays are carried out.
  • A nerve conduction test may also be conducted for gauging the functionality of the nervous system.

Treatment for Hyperesthesia

The initial step to treating this illness is to establish the source as it often relates to another condition. Healing the core condition should be the primary objective to ensure that hyperesthesia, as a symptom, recedes. Treatment is based on the deep-rooted symptoms and the established disease/ailment or state of health. Therefore, treatments differ from condition to condition. Hyperesthesia should be evaluated by the sufferer himself. Like for instance, the patient should undergo an LDL (Loudness Discomfort Level) test to determine his sound level sensitivity. A normal person would have an LDL of approximately 85 to 90 decibels, but a patient suffering from auditory hyperesthesia will have a comparatively lower LDL.

To rule out the presence of such illness a number of investigative tests like a primary check up with the general physician and neurologist, urine analyses, blood chemistry, MRI, and X-rays need to be done. If you want to rule out muscle disease (Myopathy), you need to have a biopsy of the muscle carried out.

  • Hyperesthesia treatments concentrate on the primary reason for the ailment. For instance, B-12 supplements will be recommended if the hyperesthesia is due to a deficiency in Vitamin B-12. Vitamin B12 is essential to strengthen nerve cells. Acute deficiency of Vitamin B12 can lead to damage of the nervous system. Vitamin B12 is found in animal products such as dairy, shellfish, eggs, fish, and meat and hence, vegetarians are in danger. Also, individuals suffering from dietary problems that restrict the absorption of nutrients are prone to Vitamin B12 deficiency.
  • In cases where there is a chronic spinal cord or brain illness, an assessment will be carried out and suitable cure will follow.
  • For those experiencing seizures, anti-convulsive medication can be ministered.
  • Anti-anxiety prescriptions can be suggested to those undergoing anxiety and fear in terms of the problem.
  • Analgesics are given to numb sensation while anti-anxiety and anti-seizure drugs also aid patients in this state. These drugs help reduce the strength of the uncomfortable sensitivities and offer relief to the patient.
  • It is also very beneficial for the patient to lie in peaceful, silent, calm, and dark enclosures to soothe and settle the condition.
  • Physiotherapy and aerobic breathing exercises are also quite helpful in some cases as it also facilitates restoration of oxygen in the body.
  • The patient should be made to practice yoga to ward off stress and anxiety and also to thwart repeated occurrences of hyperesthesia.
  • Cognitive Behavioral Therapy or CBT as it is known is also quite effective in limiting the agonizing reactions caused by the relevant stimuli.
  • People with hyperesthesia are advised a balanced diet rich in antioxidants.
  • A patient with auditory hyperesthesia may be asked to wear headphones or hearing aids that emit sounds or ‘pink noise’ that are in sync with the range of noises heard in the course of a normal day. The patient should wear the aids for a minimum of two hours per day for around six months or so.

Helpful Tips on Preventing Hyperesthesia

Hyperesthesia is a condition that is manageable and with proper care, it can be prevented. Certain lifestyle changes will help reduce the discomfort levels and alleviate your symptoms considerably.

Some tips to help you overcome this problem:

  • Abstain from alcohol consumption or in case it is not possible, try to lower the intake level by a great deal.
  • Practice yoga and meditation regularly to stay composed and relaxed.
  • Trim down your caffeine intake or try to get rid of the addiction.
  • Eat a well balanced nutritious diet
  • At the onset of the symptoms, lie down in a quiet, cool, tranquil, dark room and keep reminding yourself that your symptoms will pass off in a short while.

Hyperesthesia vs Allodynia

Hyperesthesia and Allodynia are two of the most commonly used terms in the world of pain and medicine research. Hyperesthesia means an amplified reaction to a painful stimulus, while on the other hand, Allodynia means a painful response to a normally harmless stimulus.

Example of Hyperesthesia: If you received a pinprick in your arm and you declared it caused you pain on a rating of 3 out of 10, then this would be your basic response. If you were then given an injection followed by a pinprick 30 minutes later and you reported pain on a rating of 6 out of 10 this would be Hyperesthesia. The stimulus needs to be painful for Hyperesthesia to occur because it is always a response to increased pain due to a harmful impulse.

Example of Allodynia: If your arm was brushed with a cotton bud, you would obviously say it was not painful, giving it 0 out of 10. If, however, your arm was injected with capsaicin followed by your arm being brushed again half an hour later, you would most probably declare the pain as 4 out of 10. This experience is known as Allodynia, a painful reaction to an innocent impact. For Allodynia to take place, the stimulus must never be painful at a normal level.

Let us now understand why they take place. First and foremost, in the wide range of pain environments, only one of these conditions will be present, not together. This is because they are instinctively different from one another.

Sensory neurons that supply your skin with nerves and vital organs more or less fall into three categories:

1) Rapidly Adapting Mechanotransducers – Neurons that respond to contact and non-toxic temperatures, conduct rapid nerve impulses, and make a division of nerve fibers called A-beta fibers.

2) Proprioceptive neurons – Neurons that sense the position of the muscles, conduct rapid action potentials, and comprise of the other compartment of nerve fibers called A-beta fibers.

3) Nociceptors – Pain-sensing neurons that react to painful thermal or mechanical stimulation. They also make up the group of neurons that counter chemical irritants like capsaicin. They conduct actions more gradually, unlike A-beta fibers. They are also unable to acclimatize to stimulation so they keep discharging until the removal of the stimulus.

These neurons consist of two categories-

  1. The lightly myelinated ones (A-delta)
  2. The unmyelinated ones (C-fibers)

The above mentioned neurons send a protrusion into the dorsal horn of the spinal cord where the incoming sensory information is processed. This processing base in the dorsal horn of the spinal cord is considered ‘the gate’. These indicators are then forwarded to the brain where the awareness of sensation takes place.

The difference between the types of fibers that transmit the information induced by the stimulus in the periphery is the physiological basis of Hyperesthesia and allodynia.

It is to be remembered that Hyperesthesia always entails a toxic stimulus which just becomes more painful when Hyperesthesia is present. The poisonous stimulus, then activates nociceptors in the periphery that send the signal onto the spinal cord. Hyperesthesia intensifies the signs of pain. This intensification occurs in the periphery or in the spinal cord through an increased synaptic conduction between the dorsal horn neuron and the nociceptor that then sends the signal to the brain. Sometimes, intensification may occur in important brain centers, i.e. perhaps after a stroke.

Allodynia entails a deadly response to a harmless stimulus. As the stimulus is harmless and mostly of an automatic type, rapidly adapting mechanotransducers or sensitized nociceptors could act as transporters. Present understanding of Allodynia advocates that nociceptor mechanical entrances do not change enough for them to carry information concerning light brushing, touching or gentle vibration in conditions where allodynia is present. It, in fact, emerges that rapidly adjusting A-beta fibers continue to be the solitary carriers of this information where allodynia is present. A-beta fibers gain access to the nociceptive channel through an unknown procedure causing changes in the spinal cord. It is not possible for A-beta-fibers to activate dorsal horn neurons that respond exclusively to painful stimulation in normal conditions. However, these same neurons begin to receive input from A-beta-fibers in allodynic conditions. This, therefore, permits A-beta information to enter the nociceptive channel provoking the awareness of pain in the brain.

Allodynia can occur rapidly, and thus, it is doubtful whether a physical change acts as a go-between in the link between neurons in the dorsal horn. It rather appears there are transformations in the neurochemistry of the ‘gate’ so that excitement can replace slow neurotransmission. As GABA is the primary inhibitory neurotransmitter in the brain that can switch from inhibition to irritation, currently, the focus has been laid on the function of GABA in Allodynia for certain ailments like epilepsy and during early neural development.

Both Allodynia and Hyperesthesia are major problems for patients with chronic pain conditions. Even slight movements like sitting, lying down, putting on clothes can be extremely painful due to Allodynia.

Allodynia is resistant to NSAID analgesics and opiates, especially in conditions concerning peripheral neuropathy due to diseases like diabetes or injury.

In case the allodynia is mild and more of an allergic reaction, the leads may still be placed within the painful area. However, in case of critical Allodynia, positioning the electrodes/leads inside the painful area might be inadvisable as it could produce a harsh eruption of the pain. This stimulation is most often recognized as painful. Therefore the best approach would be to introduce the leads on either side of the allodynic region in order to categorize it. Severe Allodynia is substantially reduced by using this strategy.  It is the key to carefully chart out the shift between the allodynic and non-allodynic areas and lay the lead precisely in that area. Even a centimeter variation could influence the success or failure of the procedure.  When the lead is placed in the center of an allodynic spot it will positively reduce allodynia.

Physical stimuli of temperature can aggravate allodynia which may cause a burning sensation and this feeling usually happens after an injury to that place. Allodynia is different from Hyperesthesia which is an extremely magnified response to a stimulus which is normally agonizing.

Hyperesthesia in Animals

Feline hyperesthesia syndrome, albeit a rare occurrence, is a frequently occurring condition in cats, particularly Burmese, Abyssinian, Siamese, and Himalayan cats. Though commonly found in mature animals, it can affect cats of all ages.

It is difficult to identify this disease as it is portrayed by brief abnormal behavior outbursts that last not more than a minute or so. There are also behavioral changes like snapping, self-harm and biting. Dogs having Canine Distemper Disease or CD also suffer from one of its particular symptoms caused by Canine Distemper Virus (CDV).

In animals, tactile hyperesthesia has been often evident as an increased sensitivity of the skin. The skin may wrinkle or convulse due to a skeletal muscle called the cutaneous trunci beneath the skin that is highly responsive when scratched or touched and the animal may react violently. The skin by itself is unable to move, it has to be stimulated by the muscle.

The animals begin to lick, bite, or scratch their skin that ultimately leads to the formation of bald patches or sores and the animal reacts sharply by barking, hissing, or snapping when patted.

A veterinarian needs to be immediately called who will examine the animal and prescribe suitable treatments that will deal with the problem. An e-collar is advised during treatment to prevent the animal from licking or biting.

Feline hyperesthesia syndrome is generally known as tactile hyperesthesia in cats, sometimes also referred to as Rolling Skin Syndrome or Twitchy Cat Disease. Suffering from this disease, many cats experience epileptic seizures. However, findings conclude this condition could also be a genetic issue as it is more prevalent in specific strains of cats like the Siamese.

Cats suffering from hyperesthesia patterns are tremendously sensitive to touch in the lumbar region.  Touching can activate a sudden reaction in them, causing them to open their eyes wide with dilated pupils followed by salivating, vocalizing, biting, scratching, mewing, or licking their tail, flank area, or back and in some cases involuntarily passing urine. They become disturbed and start running around aimlessly about the house for around 20 to 30 seconds until the feeling ceases and then they go back to being normal.

Feline hyperesthesia syndrome can really be very stressful for those cats that are affected by it as they tend to harm themselves during the uncomfortable period of going through the experience.

Fortunately, the cause of hyperesthesia is evident in animals, unlike in humans, as cats become hyperactive and aggressive.

Clinical Manifestations

Some of the clinical signs observed are:

  • Health syndromes that affect the muscles, skin, and nervous system.
  • Injuries in the spinal cord that can cause similar signs including slipped disks, arthritis, and pinched nerves.
  • Skin disorders such as fungal infections, flea, mite infections, or food allergies.

Treatment in Cats

  • The cat’s surroundings need to be made more home friendly so that it benefits from it and finds it less traumatic
  • Making it do various exercises like chasing a feather or a ball or any such activities
  • You have to make certain the cat does not take part in destructive brawls
  • Sometimes anti-depressant or anti-anxiety medications are also ministered by a neurologist.
  • Planned feeding and playing times to help keep the cat relaxed and well exercised.
  • Any type of physical activity such as scratching its back should definitely be avoided as it will cause irritation and over stimulation in the cat.
  • In some cases, a vet may advise a serotonin-enhancing drugs like fluoxetine or amitryptyline, an anti-inflammatory medication such as Prednisolone, an anti-seizure drug, such as Phenobarbital or even a mixture of the drugs to calm down a cat’s mood. A recent addition in the market is Gabapentin, a drug with both anti-seizure and analgesic properties, which is powerful for treating hyperesthesia syndrome.

However, fortunately, Hyperesthesia is a quite a minor condition and cases of cats dying from it are unknown. Once the syndrome is treated, it doesn’t progress very much and the scenario is quite positive as long as the scratching doesn’t result in a severe illness.

Steps to Take When your Cat Shows Signs of feline Hyperesthesia

Immediately schedule an appointment with your regular veterinarian as soon as you see signs of hyperesthesia in your cat. The vet will examine your cat to search for other causes and symptoms such as flea infestation, an injury, or a painful state like orthopedic, a nerve or spine problems or a skin disorder causing severe itching. If the vet cannot pin down a cause for the symptoms you will have to consult a veterinary neurologist for further tests.

Hyperesthesia Diagnosis in Cats

As of now, there are no specific tests for feline hyperesthesia. The exact cause is considered to be a kind of seizure syndrome. Therefore, the only way to identify feline hyperesthesia disorder is to exclude other causes of the incidents.

Your regular vet or the veterinary neurologist might want to run certain basic lab work such as biopsies, skin scrapings, X-rays or cultures and possibly an MRI. These tests can be totally normal where feline hyperesthesia syndrome is concerned. So, if no other particular cause can be recognized, the veterinarian may reach a diagnosis of hyperesthesia syndrome.

All these processes may take some time for completely eliminating the diverse conditions that might be the cause of the symptoms.

Conclusion

Hyperesthesia can be quite worrying for those who live with it, causing them to go through feelings of fear and anxiety. Hyperesthesia is depicted by manifold conditions that are all exemplified by irregular sharp sensitivity to stimuli causing distress or pain to the patient. If not of its own, Hyperesthesia can be a symptom of other related health condition. Your doctors will diagnose the root cause to enable effective treatment.


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