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L’allodynie mécanique masque une hypoesthésie : observations topographiques de 23 patients douloureux neuropathiques chroniques

Mechanical allodynia masking hypoaesthesia: topographic observations of 23 chronic neuropathic pain patients

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Douleur et Analgésie

Résumé

L’étiologie des allodynies mécaniques est sujette à la controverse. Dans cette recherche, 25 allodynies mécaniques stastiques (AMS), traitées par rééducation sensitive (n = 23 patients), ont été étudiées topographiquement: les AMS cartographiées (allodynographies) rétrécissent en surface. Leur mode de disparition successif a été cartographié, ainsi que l’apparition de leur hypoesthésie. Le centre de la cartographie de la dernière AMS se situe en regard du centre de la dernière cartographie de son hypoesthésie (esthésiographie secondaire): 9,7 mm en moyenne ± ET = 8,0 (étendue: 1–38 mm). Nous concluons que l’AMS disparaît vers le centre de son hypoesthésie. En présence d’une hypersensibilité au toucher, cette observation devrait aider le clinicien à identifier l’étiologie du nerf cutané lésé.

Abstract

The aetiology of mechanical allodynia is still controversial. In the present study, we investigated the precise locations of 25 static mechanical allodynias (SMA) treated by somatosensory rehabilitation (n = 23 patients): the allodynic territory mapped (allodynography) was seen to shrink. The mode of progressive regression and finally disappearance of the SMA was mapped, as was the hypoaesthesia. The center of the final SMA map is aligned with the center of the final hypoaesthesia map (secondary aesthesiography): the inter-center distance was on average 9.7 mm ± SD = 8.0 (range: 1–38 mm). We conclude that the SMA disappears in the direction of the centre of the underlying hypoaesthesia. In cases of hypersensitivity to touch, this observation should help the physician identify the damaged cutaneous nerve.

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Authors and Affiliations

  1. Centre de rééducation sensitive, clinique générale, 6, Hans-Geiler, CH-1700, Fribourg, Suisse

    C. J. Spicher, F. Mathis, N. Desfoux & F. Schönenweid

  2. Unité de physiologie, département de médecine, université de Fribourg, 5, rue du Musée, CH-1700, Fribourg, Suisse

    C. J. Spicher, E. -M. Rouiller & F. Ribordy

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  1. C. J. Spicher
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  2. F. Mathis
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  3. N. Desfoux
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  4. F. Schönenweid
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  5. E. -M. Rouiller
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  6. F. Ribordy
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Correspondence to F. Ribordy.

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Spicher, C.J., Mathis, F., Desfoux, N. et al. L’allodynie mécanique masque une hypoesthésie : observations topographiques de 23 patients douloureux neuropathiques chroniques. Douleur analg 21, 239–251 (2008). https://doi.org/10.1007/s11724-008-0111-6

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  • DOI: https://doi.org/10.1007/s11724-008-0111-6

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