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Dysesthesia may be a symptom of conditions that can cause nerve damage, such as multiple sclerosis
Dysesthesia is a type of chronic pain that may be a symptom of the following:
- Autoimmune diseases such as multiple sclerosis and acute inflammatory demyelinating polyneuropathy
- Diabetes mellitus
- Alcohol or drug withdrawal
- Peripheral neuropathies (caused by injury, metabolic disorders, toxins, and inherited factors)
- Infections such as herpes zoster, human immunodeficiency virus, Epstein Barr virus, and leprosy
- Thalamic infarct (death of brain cells due to disrupted blood supply in the thalamus)
- Cancerous tumors
- Transverse myelitis (condition in which the immune system attacks a section of the spinal cord)
- Connective tissue disorders such as Sjögren syndrome and systemic sclerosis
- Chemotherapy
- Nerve entrapment such as carpal tunnel syndrome
These conditions can cause nerve damage. When damage occurs to sensory nerves due to reduced blood supply or compression, they may cause incorrect or confused signals to the brain that result in pain and burning sensations.
What does dysesthesia feel like?
Dysesthesia can cause abnormal sensations in response to normal stimuli. For example, gentle touch may be perceived as unpleasant or painful. In some cases, it may cause insensitivity to stimuli or sensitivity in the absence of stimuli.
Symptoms are often localized (scalp, face, feet, or hands) or generalized and may vary in intensity from person to person. Dysesthesia symptoms may include:
- Itching
- Burning
- Stinging
- Feeling that something is crawling on or under the skin
- Severe, sharp, shooting, or stabbing pain
- Discomfort or pain in the absence of any stimuli or in response to harmless stimuli such as light touch
- Pins and needles sensation
- Prickling sensation
- Feeling of tightness around the chest, arms or legs (called MS hug)
- Electric shock sensation
- Feeling of cold
- Feeling of wetness
How is dysesthesia treated?
Treatment of dysesthesia largely depends on the severity of symptoms, cause, and sites affected. Many times, dysesthesia is associated with mood disturbances such as anxiety, depression, and irritability, as well as lack of sleep and fatigue. These symptoms need to be addressed through treatment.
Dysesthesia treatment may involve the following:
- Topical treatment:
- Capsaicin cream
- Local anesthetic patches
- Combination gels or creams containing amitriptyline 1% with ketamine 0.5%
- Oral medications:
- Antidepressants (such as amitriptyline)
- Anti-seizure medications or antiepileptics (such as gabapentin, pregabalin, and carbamazepine)
- Antipsychotic medications (such as pimozide and venlafaxine)
- Beta-blockers (such as propranolol)
- Cannabinoids
- Physiotherapy
- Physical barriers:
- Gloves
- Thermoplastic facemasks to be worn at night
- Night-time arm splinting
- Botulinum A injection
- Intralesional steroid shots
- Transcutaneous electrical muscle stimulation
- Narrow-band ultraviolet radiation
- Alternative treatments:
- Meditation
- Acupressure
- Acupuncture
- Deep breathing
- Biofeedback
- Yoga
- Epsom salt or oatmeal baths
- Hypnosis
Dysesthesia symptoms may resolve on their own, but they tend to recur and may worsen over time. Seek medical help if:
- Symptoms progressively worsen.
- You experience severe pain.
- Your symptoms affect your sleep, work, or social life.
- You develop mood changes such as irritability, depression, or anxiety.
