[Congenital insensitivity to pain: difficulty of management]

Rev Stomatol Chir Maxillofac. 2012 Feb;113(1):46-9. doi: 10.1016/j.stomax.2011.08.009. Epub 2011 Sep 14.
[Article in French]

Abstract

Introduction: Congenital insensitivity to pain with anhidrosis (CIPA) is a very rare disorder, most often of genetic origin.

Case report: The authors present the case of two siblings, 10 and 13 years old, both followed-up since the age of 2 for CIPA diagnosed after discovering insensitivity to pain during iterative falls, burns, and of severe oro-digital self-mutilating behavior. Sural nerve biopsy and an electromyogram confirmed the diagnosis.

Discussion: CIPA with anhidrosis is a very rare disease. It is characterized by unexplained fever episodes, anhidrosis, pain insensitivity, self-mutilating behavior, and sometimes mental retardation. Complications of this insensitivity (non-treated fractures, burns, and oro-digital mutilation) may be lethal. Treatment remains preventive. The patient must observe a very strict hygiene. Prevention for maxillofacial involvement consists in breaking the cycle of oral self-mutilation.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adolescent
  • Child
  • Directive Counseling
  • Female
  • Humans
  • Hypohidrosis / complications
  • Hypohidrosis / diagnosis
  • Intellectual Disability / complications
  • Intellectual Disability / diagnosis
  • Male
  • Pain Insensitivity, Congenital / complications
  • Pain Insensitivity, Congenital / diagnosis*
  • Pain Insensitivity, Congenital / therapy*
  • Self Mutilation / complications
  • Self Mutilation / prevention & control
  • Siblings
  • Stomatognathic Diseases / complications
  • Stomatognathic Diseases / diagnosis