RT Book, Section
A1 Ropper, Allan H.
A1 Samuels, Martin A.
A1 Klein, Joshua P.
A1 Prasad, Sashank
SR Print(0)
ID 1162589974
T1 Pain
T2 Adams and Victor's Principles of Neurology, 11e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9780071842617
LK accessmedicine.mhmedical.com/content.aspx?aid=1162589974
RD 2024/04/23
AB The  ambiguity  with  which  the  term  pain  is  used  is  responsible  for  some  of  our  difficulty  in  understanding  it.  One  aspect,  the  easier  to  comprehend,  is  the  transmission  of  impulses  along  certain  pathways  in  response  to  potentially  tissue-damaging  stimuli,  that  is,  nociception.  Far  more  abstruse  is  its  quality  as  a  mental  state  intimately  linked  to  emotion,  the  quality  of  anguish  or  suffering  that  defies  definition  and  quantification,  or  “a  passion  of  the  soul,”  in  the  words  of  Aristotle.  This  duality  (nociception  and  suffering)  is  of  practical  importance,  for  certain  drugs  or  surgical  procedures,  such  as  cingulotomy,  may  reduce  the  patient’s  reaction  to  painful  stimuli,  leaving  awareness  of  sensation  largely  intact.  Further  complexities  are  that  the  symptom  of  pain  may  persist  despite  interruption  of  neural  pathways  that  abolish  all  sensation  (i.e.,  denervation  dysesthesia  or  anesthesia  dolorosa),  or  that  pain  may  continue  to  be  perceived  from  the  absent  part  of  an  amputated  limb  (“phantom  pain”).  Finally,  pain  can  be  evoked  by  almost  any  sensory  modality,  such  as  touch,  pressure,  heat,  or  cold,  if  it  is  intense  enough.