To the Editor.
—We have observed a 17-year-old boy with congenital absence of pain sensation and no demonstrable abnormalities in the peripheral and central pain-transmitting pathways.The patient, fully described earlier in this journal,1 had no neurologic defects except universal analgesia. He did not react to routine painful maneuvers, nor to high-intensity electrical stimulation of skin, nerve trunks, dorsal roots, tooth pulp, and corneal mucosa. Sharp-dull and hotcold discrimination were normal, as were proprioceptive sensation and deep reflexes. He had normal unmyelinated and myelinated fibers in skin nerve branches, and the corneal reflex latency was in the normal range. Stimulation of tooth pulp with electrical pulses evoked large cortical potentials in vertex recordings. On psychometric testing he was classified as dull normal, and his emotional reactions to psychological distress were adequate.This rare condition can be considered as a model of indifference to pain resulting from a central error
Fabbri A, Fraioli F, Gnessi L, et al. Is Calcitonin an Analgesic Hormone? Arch Neurol. 1983;40(1):64. doi:10.1001/archneur.1983.04050010084031
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