The hypoesthesia it is a perceptual problem in which there is a sensory distortion. Specifically, a partial or total reduction in skin sensitivity appears. A patient with hypoesthesia may have less sensitivity to pain, changes in temperature, or pick up tactile stimuli in an attenuated manner..
This condition can appear from injuries that involve the nervous system, both central and peripheral (nerve damage). It is often a symptom of diseases such as multiple sclerosis, diabetes, strokes, or tumors..
Hypoesthesia has also been found in patients with depression, in soldiers during war, or in very intense emotional states. Hypoesthesia can also appear from the administration of drugs or drugs that have anesthetic effects..
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It is important not to confuse hypoaesthesia with paresthesia. The latter refers to an abnormal sensation of tingling or numbness in some part of the body. It doesn't have to be unpleasant.
On the other hand, it is useful to clarify that hypoesthesia is different from dysesthesia. This is an unpleasant sensation, which can be painful or uncomfortable. It manifests as tingling, burning, stinging or cramps, which bother the patient.
As for the term hypoalgesia, it refers exclusively to a decrease in the ability to feel pain. Hypoaesthesia encompasses hypoalgesia, and also includes lack of sensitivity to temperature and skin contact in general.
While anesthesia, it would be extreme hypoesthesia. That is, a total loss of sensitivity in a certain area of the body.
The opposite of hypoesthesia would be hyperesthesia, which consists of an increase in the sensitivity of the skin. Pain (hyperalgesia), temperature, or any other skin sensation may be felt more.
Hypoaesthesia refers to a symptom itself rather than an isolated condition. That is, it is the consequence of another disorder or injury. In addition, the level of sensory perception in the affected area varies depending on the case..
There may be a small difference in the sensitivity of the skin between the right and left side, although there are cases in which there is complete insensitivity to pain.
Furthermore, hypoesthesia tends to affect the arms and legs first before the trunk. If it involves the trunk, it is possible that there is some type of demyelination or injury to the spinal cord.
A person with hypoesthesia feels that some part of their body is "numb." This means that there is a reduction in skin sensitivity. Thus, it can capture temperature, pain or any sensory stimulus much less intensely than normal.
However, according to Hallett, Ston & Carson (2016), most patients are not aware of their hypoesthesia until the first neurological examination is performed..
They may know sooner if they accidentally burn themselves when they don't feel the heat, or scratch or bruise their skin without noticing it at the time. It is dangerous because some harmful or harmful stimulus could appear and not react in time to avoid it.
Naturally, when you reach very advanced ages, the skin loses sensitivity. That is why it is not strange that the elderly are injured or do not protect themselves from the cold or heat, which endangers their health..
In some cases, they may show that they cannot feel an arm or a leg. Although it seems that this is more due to the loss of the "idea of the limb" rather than a skin alteration..
This is demonstrated because patients with loss of sensory function can only move their arm or leg when looking at them, and cannot move if their eyes are closed..
On the other hand, after certain brain damage, such as can occur after a stroke, hypoesthesia or hemihypoesthesia may appear. In the latter case, there is a reduction in sensitivity in only one half of your body. Patients may report that they feel "split in half".
The affected parts can be small areas, such as the face, or larger areas. Normally, hypoesthesia occurs more intensely in the front of the trunk than in the back.
On the contrary, in other cases patients may lose skin sensitivity throughout the body. Normally this type of hypoesthesia is short-lived and usually occurs during very stressful events. Although hemihypoesthesia is much more common.
The causes of hypoesthesia can be very varied, since this is a symptom of some neurological condition mainly.
When symptoms occur irregularly in the body, they can be difficult to distinguish from normal conditions, or they can stem from other conditions such as peripheral neuropathies.
If the hypoaesthesia goes away on its own, it is probably due to normal or mild conditions. It stands out for the subsequent appearance of tingling in the area. Temporary hypoesthesia tends to appear after a continuous uncomfortable position that compresses a nerve.
This symptom can arise from non-serious circumstances, but it can also be a sign of more dangerous health conditions. If it happens suddenly and extends over time, it is important to go to a health professional to find out its origin.
It is possible that it appears only due to a lack of blood flow in an extremity, or due to an injury to a nerve. Some of the most common causes of hypoesthesia are:
Interruption of blood flow in certain arteries, causing a lack of oxygen in the cells. As a consequence, it leads to injuries in these. A related disease that produces hypoesthesia is Raynaud's syndrome..
For example, such as a herniated intervertebral disc (herniated disc). It is a wear of the discs that are between the vertebrae, producing pressure on the nerves. This could cause hypoesthesia, but also pain in some areas of the body.
These consist of a condition of the peripheral nervous system, that is, some damage to the nerves.Another example is the pathologies of the sciatic nerve, which goes from the lumbar vertebrae to the knee..
On the other hand, any deviation of the spine (such as scoliosis) can also cause a compression of a nerve that generates hypoesthesia.
A final example would be carpal tunnel syndrome, where there is numbness on the inside of the wrist due to nerve pressure.
Certain drugs or drugs, for example, those that have sedative effects such as certain anxiolytics. Some treatments such as radiotherapy or chemotherapy, lead poisoning ... As well as excessive consumption of alcohol or other drugs that produce relaxation.
For example, during an episode of great stress, the pain or shock may feel lessened. This has been observed in soldiers during wartime.
During a depressive episode, the patient may find himself immersed in great apathy. Thus, they do not enjoy things as they used to..
It has also been observed that he can capture with less intensity the stimuli around him such as colors, sounds, and of course, tactile sensations (appearing hypoesthesia).
- Damage to the nervous system due to some type of trauma, stroke, tumors ... that compromise sensory function.
- Diseases such as fibromyalgia, epilepsy, diabetes, migraine or hypothyroidism also have hypoaesthesia as a symptom in some patients.
- Demyelinating diseases, that is, those in which there is a progressive loss of myelin in the nervous system. An example is multiple sclerosis.
- Congenital syndromes such as Tolosa-Hunt Syndrome, or Brown Sequard Syndrome.
- Herpes zoster: it is an infectious disease that damages the sensory nerve ganglia and can cause severe pain and hypoesthesia.
- Unbalanced diet that leads to low levels of calcium, sodium, potassium or vitamin B12, can increase episodes of hypoaesthesia.
- The bite or sting of a poisonous insect or animal.
There are currently difficulties in reliably diagnosing hypoesthesia. This occurs because there are no specific criteria and because it is not as easy to assess as movements or strength..
In addition, it is very likely that the examiner during the test will suggest to the patient with the sensations, and inaccurate results may be obtained. That is, the patient may not know how to verbally express what he is feeling.
In this way, if you are asked to say "yes" when you feel something or "no" when you do not feel it during the exam; the patient may consider that “no” means feeling the stimulus a little less than before. This occurs because the perception of sensations can be very subjective..
However, the main evaluation is still touching the skin with a brush, sponge or gauze. The pathological response would be a reduction in perception and numbness. The examiner will determine if the skin's reaction to the sensory stimulus is below the normal threshold..
In the ICD-10, a diagnostic manual of the World Health Organization (WHO), hypoesthesia is included. It appears in a section called "symptoms and signs involving the skin and subcutaneous tissue", specifically within "alterations in skin sensitivity".
Mainly the diagnosis should be focused on finding the disease that is causing the hypoesthesia. It is advisable to perform a brain scan to see if there are damaged areas, such as an magnetic resonance (MRI) or a computed tomography (CT) scan.
Depending on the symptoms, a blood test, x-rays, ultrasound of the blood vessels or electromyography may also be carried out..
The treatment of hypoesthesia is highly variable, as it depends on the condition causing this symptom. If the cause is not treated, hypoesthesia may not stop.
If it is less severe, it may disappear on its own over time, or be position dependent. How it happens in carpal tunnel syndrome.
Physical therapy, electrical therapy, and nutritional supervision are usually combined. In some cases, surgery may be necessary to remove the compression on a nerve that is causing the hypoesthesia.
Electrical stimulation consists of a device that produces electrical currents. This is connected to adhesive patches that are placed on the patient's skin, causing motor or sensory responses.
Another option is the stimulation of the affected peripheral nerves through biofeedback (Hallett, Stone & Carson, 2016).
In general, to strengthen muscles and gain sensitivity, it is ideal to combine treatment with physical therapy.
An adequate diet is recommended to control episodes of hypoesthesia due to lack of nutrients. How to eat foods with vitamin B12 (beef or pork liver, beef, clams, mackerel, salmon, dairy and eggs). As well as reducing the consumption of coffee and alcohol.
It is also important to be careful to avoid injuries, burns, cuts, bumps, or falls..
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