Clin J Pain 2002 May/June;18(3):191-195
Chantal Morin, Ph.D.*; *M. Catherine Bushnell, Ph.D.; †Marla B. Luskin, Ph.D.; ‡A. D. (Bud) Craig, Ph.D.
*Departments of Anesthesiology, McGill University, Montréal, Québec, Canada; †Department of Cell Biology, Emory University, School of Medicine, Atlanta, Georgia; and ‡Division of Neurosurgery, Barrow Neurologic Institute, Phoenix, Arizona, U.S.A.
To investigate integrative thermal perception in a patient with multiple sclerosis.
Quantitative thermosensory testing was used to evaluate pain and other sensations produced by heat, cold, and the thermal grill pain illusion.
The authors report on a 43-year-old patient with central pain manifest most strongly in her left arm and hand, contralateral to an upper cervical spinothalamic lesion due to multiple sclerosis.
Outcome Measures and Results:
Quantitative thermosensory testing showed that the patient had heat hypalgesia (no pain with stimuli of 45–50°C) and cold allodynia (pain with innocuous cool temperatures, 25–10°C). Whereas healthy subjects rated 20° and 40°C as nonpainful, but the thermal grill (intermixed 20 and 40°C stimuli) as painful, the patient rated the thermal grill as less painful than 20°C.
The absence of thermal grill-evoked pain is consistent with the hypothesis
that in some cases of central pain the loss of the thermosensory pathway
results in disruption of the normal cold inhibition of burning pain.
Copyright © 2002 Lippincott Williams & Wilkins