Indiferença congênita, generalizada, à dor

Abstract

É relatada a observação de um menino, atualmente com 3½ anos de idade, que apresenta, como única manifestação anormal, indiferença generalizada à dor, notada desde os primeiros meses de vida. Os autores fazem, a propósito do caso, breve revisão do assunto.

Congenital insensitivity to pain: A critique.

“…WITHOUT PAIN Whereas the chances for healthy survival are greatly impaired in the absence of a sense of pain, no such generalization seems possible about the development of a "normal" or "healthy" personality. We have indicated above that Juliao and Brotto (1955) reported that their case was a behavior problem. This is rare.…”

“…Trophic disturbances may be excessive (Petrie, 1953) or absent (Ervin & Sternbach, 1960), or range between these. With respect to behavior, both college students cited above were normal, but another patient was said to have been a behavior problem (Juliao & Brotto, 1955). Self-mutilation and disfigurement are frequent (Boyd & Nie, 1949;Durand & Belotti, 1957) but not universal (Jewesbury, 1951, Cases 1 and 3; Ervin & Sternbach, 1960, Cases 1, 2, and 3).…”

“…Here we would include the cases of Boyd and Nie (1949); Nissler and Parnitzke (1951); Cerny-Waldvogel (1952); Westlake (1952); Girard, Devic, and Garin (1953); Juliao and Brotto (1955); Lamy, Garcin, Jammet, Aussannaire, Lambert, Thiriez, and Grasset (1956); J£quier and Deller (1956); Schachter (1956); Durand and Belotti (1957); Ervin and Sternbach's (1960) Case 2.…”

“…Where one young coed shows some impairment of temperature discrimination (Cohen et al, 1955), her Canadian counterpart is normal in this respect (McMurray, 1950). Some children may react to hot and cold as to tepid (Durand & Belotti, 1957;Girard et al, 1953), while others may find extreme cold "unpleasant" (Jequier & Deller, 1956;Juliao & Brotto, 1955). Trophic disturbances may be excessive (Petrie, 1953) or absent (Ervin & Sternbach, 1960), or range between these.…”

Theories of pain and congenital universal insensitivity to pain.

“…In view of the definition given above it is not surprising that he could assign none to Group i. Into Group n he placed the following: McMurray (1950); Dearborn (1932); Jewesbury (1951) cases 1 and 3; Kipnis, Cohen, Kubzansky, and Kunkle (1954); Cohen, Kipnis, Kunkle, and Kubzansky (1955) (same case); Ervin and Sternbach (1960) cases 1 and 3; Fanconi and Ferrazzini (1957) case 3;Jewesbury (1951) case 4;Rose (1953); Ford and Wilkins (1938) case 1; Boyd and Nie (1949); Nissler and Parnitzke (1951); Cerny-Waldvogel (1952); Westlake (1952);Girard, Devic, and Garin (1953); Juliao and Brotto (1955); Lamy, Garcin, Jammet, Aussannaire, Lambert, Thiriez, and Grasset (1956); Je 'quier and Deller (1956); Schachter (1956); Durand and Belotti (1957); Ervin and Sternbach (1960) case 2.…”