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December 1963

Congenital Indifference to PainAn Anatomicopathologic Study

Author Affiliations

From the Kresge Neurology Research Laboratories and the Department of Neurology, University of Michigan Medical Center.

Arch Neurol. 1963;9(6):635-640. doi:10.1001/archneur.1963.00460120085009

A sufficient number of studies of patients with congenital indifference to pain have been made to establish the disorder as a definite clinical entity. Congenital indifference to pain can be separated from insensitivity to pain associated with hysteria, emotional stress, analgesic drugs, or disturbances of the primary pain pathways in the peripheral or the central nervous system. In true congenital indifference to pain, the patient can clearly perceive painful stimuli, but such stimuli are not accompanied by displeasure or discomfort. Individuals with congenital indifference to pain often suffer mutilating injuries because this lack of appreciation of pain as an unpleasant sensation eliminates normal reactions to dangerous stimuli. Other patients, however, have learned early in life to assess the degree of painful stimuli and thereby avoid serious injury. Reviews of congenital insensitivity to pain, notably those of Critchley1 and of Odgen, Robert, and Carmichael2 are recent; therefore, no evaluation

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