Egloff Niklaus, Gander M-L, Gerber S, von Känel R, Wiest R
Kompetenzbereich für Psychosomatische Medizin, Universitätsklinik für Allgemeine Innere Medizin, Inselspital, Universitätsspital Bern.
Praxis (Bern 1994). 2010 Jun 23;99(13):797-801. doi: 10.1024/1661-8157/a000173.
We present the case of a 48-year old man who, eight years after an industrial accident, presents with chronic right-sided nondermatomal pain and hypaesthesia to heat and touch. During symmetric peripheral touch functional magnetic resonance imaging revealed hypometabolism in the left thalamus, somatosensory cortex, and anterior cingulate cortex. Pain-associated nondermatomal somatosensory deficits (NDSDs) localizing to one side of the body are a frequent clinical entity, which are often triggered by an accident. The tendency of NDSDs to extend to adjunct ipsilateral body parts and to become chronic points to maladaptive adjustment of pain-processing areas in the central nervous system. Psychological stress prior to or around the triggering event seems an important risk factor for NDSDs.
我们报告了一例48岁男性病例，该患者在一次工业事故八年后，出现右侧慢性非皮节性疼痛以及对热和触摸感觉减退。在对称外周触觉功能磁共振成像检查中，发现左侧丘脑、体感皮层和前扣带回皮层存在代谢减退。局限于身体一侧的疼痛相关非皮节性躯体感觉缺陷（NDSDs）是一种常见的临床情况，常由事故引发。NDSDs扩展至同侧相邻身体部位并发展为慢性的倾向，表明中枢神经系统疼痛处理区域存在适应性不良调整。触发事件之前或期间的心理压力似乎是NDSDs的一个重要危险因素。
