DYSESTHESIA: SYMPTOMS, TYPES AND CAUSES - NEUROPSYCHOLOGY - 2025

The dysesthesia is a neurological disorder characterized by weakened or altered sensitivity of the senses, especially touch. This condition causes an abnormal and unpleasant sensation that can be both spontaneous and provoked.

In this sense, dysesthesia is conceptualized as a type of painful paresthesia. The most typical case of dysesthesia is formed through the experience of a burning pain caused by different polyneuropathies.

The word dysesthesia comes from the Greek, where "dis" means abnormal and "esthesia" means sensation. Thus, this phenomenon is described as an unpleasant and abnormal sensation of the sense of touch. Normally, this disorder generates the experience of pain, but it can also generate unpleasant or strange tactile sensations but not painful.

Symptoms

This alteration is caused by lesions in the central and peripheral nervous system, specifically, it is caused by conditions in the pain transmission system.

The main sensations that dysesthesia usually generates are: pricks, itching, electric shock, a sensation of humidity, tingling, burning, irritation and numbness. All these manifestations are experienced due to an increase in the person's pain threshold.

The symptoms of this alteration can affect any region of the body, although the most sensitive are usually the mouth, scalp and legs.

At present, dysesthesia is a neurological disorder that is observed in a wide variety of pathologies, which is why it presents a very varied etiology.

Types

Dysesthesia is a type of neurological disorder that is characterized, in general, by presenting an abnormal and unpleasant sensation. It constitutes an alteration of the tactile superficial sensitivity that generates symptoms such as tingling, pricking, irritation sensations or numbness.

All cases of dysesthesia present a similar manifestation, since this alteration constitutes more a symptom than a disease itself. However, in the clinical setting, different types of dysesthesia can be classified according to the region of the body affected.

Cutaneous dysesthesia

The presence of cutaneous dysesthesia has been determined, which is characterized by the experience of discomfort or pain when touching the skin when it comes into contact with normal stimuli.

People with cutaneous dysesthesia can have serious difficulties to function properly, since any slight contact of their skin with an external object (including clothing) generates painful and / or unpleasant sensations.

However, in these cases, the degree of painful sensation can vary and range from a slight tingling to the experience of overwhelming and disabling pain.

Dysesthesia of the scalp

On the other hand, the diagnosis of dysesthesia in the scalp has now been established. People with this condition do not present any type of sensory alteration in the skin, except in their capillary regions.

Dysesthesia of the scalp is mainly characterized by the experience of pain or burning sensations on the surface of the cranial skin, as well as the suffering of excessive itching of the scalp.

Occlusal dysesthesia

Finally, the last type of dysesthesia is known as occlusal dysesthesia or phantom bite. This condition is characterized by affecting the dental region of the person.

It is a very rare alteration experienced by individuals who have undergone dental procedures. These subjects feel pain and unpleasant sensations in their dental regions and believe that the upper region of the mouth does not fit properly with the lower region.

In this case, the dysesthesia phenomenon is usually classified as a somatoform disorder, as with the other "phantom phenomena" it usually presents contaminating psychological disorders.

Causes

Dysesthesia is a condition that is caused by specific lesions in both the central nervous system and the peripheral nervous system.

This condition involves the pain transmission system, which is closely linked to the spinal cord, but is also processed by various regions of the brain such as the thalamus.

For this reason, lesions or functional alterations both in the brain and in the spinal cord and the regions that join both structures, can carry out the development of dysesthesia.

Despite not being a highly prevalent neurological disorder, dysesthesia presents a large number of pathologies related to its etiology.

In general, it is argued that this condition is always secondary to a primary disease, which would be responsible for the functional changes in the transmission of painful and sensitive stimuli.

Diabetes

Diabetes mellitus is a group of metabolic disorders characterized by the presence of persistently high concentrations of glucose in the blood.

This pathology is highly prevalent worldwide and is caused by a defect in insulin production.

The symptoms of diabetes are very varied, including fatigue, tiredness, visual disturbances, abdominal pain, irritability or weight loss. Likewise, although it is not one of the most common manifestations, many people with diabetes can present dysesthesia.

Guillain Barre syndrome

Guillain-Barré syndrome is a serious condition that develops when the body's immune system attacks part of the nervous system by mistake.

This disease causes the inflation of different brain nerves, a fact that causes muscle weakness or paralysis. Likewise, among the symptoms generated by this pathology, dysesthesia stands out, which can be experienced frequently in these cases.

Peripheral neuropathy

Peripheral neuropathy is a group of diseases of the peripheral nervous system that are characterized by generating brain damage.

These alterations can be caused by various conditions such as herpes infection, neurotoxins or effects of chemotherapy drugs and usually degenerate in situations of insensitivity, dysesthesia and allodynia.

Polyneuropathies

Polyneuropathies are complex neurological conditions that present a high prevalence in the adult population.

It is a pathological entity that encompasses both inflammatory and degenerative diseases of the peripheral nervous system. That is, it constitutes any alteration that affects the peripheral nerves of the brain.

This disease usually generates a high sensory, motor and vegetative affectation, causing a great variety of normally serious symptoms, of which one of the most prevalent is dysesthesia.

Abstinence syndrome

The withdrawal syndrome refers to a set of both physical and psychological reactions that a person addicted to a substance experiences when they stop using it.

The syndrome can occur in some psychological pathologies such as emotional dependence. The symptoms of this condition usually vary depending on the substance to which the person is addicted.

With regard to dysesthesia in these cases, it is a rare symptom but one that some subjects addicted to alcohol may experience when they stop drinking and develop the withdrawal syndrome itself.

Multiple sclerosis

Multiple sclerosis is a disease characterized by the appearance of demyelinating, neurodegenerative and chronic lesions of the central nervous system.

Multiple sclerosis presents a wide symptomatology, incorporating asthenia, loss of muscle mass and strength, incoordination of movements, dysarthria, respiratory failure, spasticity, cramps, sexual dysfunction, cognitive problems and dysesthesia.

Dental interventions

Dental interventions are related to cases of occlusal dysesthesia or phantom bite.

This alteration is slightly different from the other types of dysesthesia, since the painful and / or unpleasant sensations are subject to cognitive elements closely related to the experiences lived in a previous dental intervention.

In this sense, occlusal dysesthesia is considered a type of somatoform disorder in which the person experiences a notable distortion regarding the functioning and structure of their dental regions.

Gangliosidosis

Gangliosidosis are a group of lysosomal storage pathologies that are due to an accumulation of gangliosides (a type of sphingolipid) in the neurons of the brain.

This hereditary pathology causes a dysfunction of the lysosomal enzymes, a fact that causes the development of different neurological and physical disorders, including dysesthesia.

Chemotherapy-induced peripheral neuropathy

Chemotherapy-induced peripheral neuropathy is a fairly common type of peripheral neuropathy that is characterized by being caused by the direct effects of chemotherapy.

This condition mainly generates dysesthesia, causing symptoms such as tingling or numbness. Symptoms usually begin in the hands and feet and gradually move up the lower and upper extremities.

Dèjerine-Roussy syndrome

Finally, Dèjerine-Roussy syndrome or thalamic syndrome is a pathology that causes a sensory loss of all forms of sensation in a half body due to suffering from a lesion of the thalamus of the contralateral brain.

References

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2. Hara, ES, Matsuka, Y., Minakuchi, H., Clark, GT, & Kuboki, T. (2012). Occlusal dysesthesia: a qualitative systematic review of the epidemiology, aetiology and management. Journal of Oral Rehabilitation, 39 (8): 630-638.
3. Hoss, D., & Segal, S. (1998). Scalp dysesthesia. Archives of Dermatology, 134 (3). doi: 10.1001 / archderm.134.3.327.
4. Tsukiyama, Y., Yamada, A., Kuwatsuru, R., & Koyano, K. (2012). Bio-psycho-social assessment of occlusal dysaesthesia patients. Journal of Oral Rehabilitation, 39 (8).