Hyperesthesia – what is it and what can we do about it?

Hyperesthesia is considered a type of neuropathic pain and is, therefore, caused by a disorder of the nervous system.

It can be a bewildering and distressing condition, for there are many variations and it also has multiple possible causes. Determining the cause of this disorder is rarely straightforward.

Fortunately, there are many possible treatments, including a few home remedies that the patient may try. If those do not work, however, they should see a doctor.

 

What is Hyperesthesia?

Hyperesthesia (or hyperaesthesia) is an abnormal sensitivity to stimuli, and it can affect any of the senses.

This condition is thus classified by the sense affected, so tactile hyperesthesia, for example, describes a condition in which the sense of touch is abnormally sensitive.

The International Statistical Classification of Diseases and Related Health Problems (ICD) describes it as one of over 100 peripheral neuropathies.(1)

Such disorders affect the peripheral nervous system and interrupt or distort signals between the brain and the rest of the body.

The International Association for the Study of Pain defines allodynia and hyperalgesia as types of hyperesthesia. (2)

In allodynia, the patient feels pain when exposed to a stimulus that normally does not cause pain. For example, a gentle touch will feel painful to somebody with allodynia. In hyperalgesia, the patient is abnormally sensitive to things that do usually cause pain.

Tactile hyperesthesia can affect cats as well as humans.

The feline form of tactile hyperesthesia (feline hyperesthesia syndrome) is sometimes called Twitchy Cat disease or Rolling Skin syndrome.

According to Alexander de Lahunta of the College of Veterinary Medicine at Cornell University, the condition might be a seizure disorder since many cats have epileptic seizures shortly after a bout of this health condition.(3)

He speculates that there is also a genetic component, as it’s more common in certain breeds like the Siamese.

 

Causes

According to Sana Saleem, who wrote for “Clinical Medicine,” this disorder has multiple causes.(4) It can also be temporary or chronic. Excessive consumption of caffeine and/or unusual sensitivity to caffeine can cause temporary hyperesthesia.

The caffeine stimulates the spinal cord and other parts of the central nervous system to an abnormal degree. In this case, the symptoms stop after about three to five hours.

In many cases, though, this condition is a symptom of another disorder.

The Patient Help website lists shingles and radiculopathy as among the more common causes of tactile hyperaesthesia.(5)

Peripheral neuropathy caused by diabetes or injury may also result in tactile hyperaesthesia. Excessive and regular consumption of alcohol can temporarily induce tactile hyperaesthesia by stimulating the nervous system.

In children, this condition often accompanies attention-deficit hyperactivity disorder (ADHD), autism and some forms of mental retardation.

According to The Hyperacusis Network, auditory hyperesthesia can be caused by injuries to the head or ear, prolonged exposure to loud noises, temporomandibular joint (TMJ) syndrome, Meniere’s disease, Lyme disease or Superior Canal Dehiscence Syndrome (SCDS).(6)

Dr. Daniel Cameron, an authority on Lyme disease, wrote that Lyme disease often causes hyperosmia.(7)

One study indicated that about 50 percent of patients with Lyme disease develop a heightened sense of smell. Far from a being a super power, hyperosmia can cause the patient discomfort and even make them sick.

 

Symptoms

Common symptoms include restlessness, confusion, disorientation, difficulty sleeping, dizziness, headache and nausea.

The symptoms do vary, as there are several different types of hyperesthesia. As already mentioned, tactile hyperesthesia is an abnormally acute sense of touch.

Other types of hyperesthesia include the following:(1)

» Hypergeusia or abnormally sensitive taste
» Hyperosmia or olfactory hyperesthesia, which is an abnormally strong sense of smell
» Hyperacusis or auditory/acoustic hyperesthesia, which is abnormally acute hearing
» Optic hyperesthesia, in which the eyes are abnormally sensitive to light

This condition can also affect the muscles and make them extremely sensitive to fatigue or pain.

 

Treatment

The first step in treating this disorder is determining the cause, because it is often a symptom of another condition.

Treating that condition will help bring the hyperesthesia under control.

The patient should also have the hyperesthesia itself evaluated.

For example, the Hyperacusis Network recommends having a patient’s Loudness Discomfort Level established by a doctor who specializes in hearing problems.(8)

An LDL is a test that determines what level of sound causes a patient discomfort. A normal person has an LDL of 85 to roughly 90 decibels, which means they can tolerate noises as loud as a motorcycle 25 feet away from them.

A patient with auditory hyperesthesia will have a significantly lower LDL.

Home remedies for this condition include providing the patient with a quiet and calm place in which to rest and adding Vitamin B12 to their diet.

According to the University of Maryland Medical Center, Vitamin B12 helps nerve cells stay healthy.(9)

People with a Vitamin B12 deficiency will develop an array of symptoms including tingling in the toes and fingers, numbness, fatigue, nervousness and shortness of breath. Severe cases of Vitamin B12 deficiency can cause nerve damage.

Older people are more susceptible to Vitamin B12 deficiency because their bodies produce less stomach acid which is needed to properly digest Vitamin B12.

Since Vitamin B12 is found only in animal products like eggs, dairy, fish, shellfish, and meat, vegetarians and vegans are also at risk. People with eating disorders or conditions that affect the body’s ability to properly absorb nutrients, such as Crohn’s disease, can also develop Vitamin B12 deficiency.

Weight loss surgery and some medications can also increase the risk of developing Vitamin B12 deficiency.

The doctor may recommend various therapies to help the patient develop a normal tolerance for stimuli. For example, they may have a patient with auditory hyperesthesia wear headphones or hearing aids that emit “pink noise” or sounds that match the spectrum of noise heard throughout the typical day.

The patient will typically have to wear the device for at least two hours a day for roughly six months.

 

Studies

There have been many studies about this disorder, for at least some types have been known since the 19th century.

A Dr. Henley Thorp describes optical hyperesthesia in the 24th volume of the “Dublin Quarterly Journal of Medical Science” in 1857.(10)

As per the article, it is a symptom of an eye condition he called “strumous ophthalmia.”

A 2015 study published in the “Journal of Thoracic Oncology” described cases of hyperesthesia in patients with cancer.(11)

The researchers tracked seven patients over an 18-year period who had been treated with radiation therapy and may have also had chemotherapy.

The patients were all treated for cancers located in their chests, and they all developed allodynia and/or hyperalgesia. The researchers determined that the radiation therapy was responsible. Happily, they also found medications that provided relief.

There have been a number of clinical trials testing various treatments for this disorder.

For example, researchers at the Thomas Jefferson University conducted a study testing the effectiveness of medication called dihydroergotamine mesylate on patients whose migraines were accompanied by tactile hyperesthesia of the face.(12)

 

Conclusion

Hyperesthesia describes a multitude of conditions that are all characterized by abnormally heightened sensitivity to stimuli which can cause the patient pain or distress.

There are steps the patient can take to get relief:

» Set up a quiet room where they can rest and reduce their exposure to distressing stimuli
» Reduce alcohol and/or caffeine consumption
» Add Vitamin B12 to their diet, especially if they belong to a group likely to have a deficiency, e.g. vegetarian, older person, etc.
» If those home remedies don’t work, have a doctor evaluate the hyperesthesia and identify its cause
» Follow the recommended therapy for desensitization


References

(1) http://icdlist.com/icd-10/R20.3

(2) http://www.iasp-pain.org/Taxonomy

(3) http://www.vet.cornell.edu/fhc/health_information/HyperesthesiaSyndrome.cfm

(4) http://medicalopedia.org/2462/hyperesthesia-causes-diagnosis-and-treatment/

(5) http://www.patienthelp.org/diseases-conditions/hyperesthesia.html

(6) http://www.hyperacusis.net/what-is-it/what-causes-this/

(7) http://danielcameronmd.com/whats-that-smell/

(8) http://www.hyperacusis.net/what-is-it/4-types-of-sound-sensitivity/

(9) http://umm.edu/health/medical/altmed/supplement/vitamin-b12-cobalamin

(10) https://books.google.com/books?id=DwMHAAAAcAAJ

(11) http://www.jto.org/article/S1556-0864(15)32374-1/pdf

(12) https://clinicaltrials.gov/ct/show/NCT00203268