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  1. #1
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    Loss of tactile sensation

    I'm new here and will introduce myself a little later but what led me to find this place today is questions about my husband...

    He has been previously diagnosed with PTSD, with Major Depressive Disorder with mixed emotional features (whatever that means), and I'm sure bipolar was on the list at one point.

    The nightmares and flashbacks have decrease greatly in the 9 yrs I've known him, the depression still flares up...but the symptom that we need to understand and find a way to control is total body numbness.

    What he experiences is not a pins and needles type of thing, but a loss of tactile sensation - he can't feel what he is touching/holding or things that touch him...

    First occurance was about 6 yrs ago after he got a cracked mercury filing replaced - we went to a specialist because of the mercury released during the removal, the procedure involved some big dental damn, and suction hoses and a rather impatient/ramy dentist - my husband definately experienced a trauma response back to childhood sex abuse while in the chair...but when he started to go numb that night our focus was all on the possibility of mercury poisoning.

    Since then he had about 4 full blown reocurances (lasting 2 to 4 wks) of the numbness/loss of sensation in the next 5 yrs and now twice in the last 6 months. He would also have moments where he would feel the degree of sensation fade for an hour or so and then pass. He tends to get really disoriented while it is happening - he is always hypervigalent, and having one sense off just makes the others work even harder, and being anywhere with a lot of stimuli starts to overwhelm him - then he starts to wonder if he can trust his other senses, like if he is talking on the phone but can't feel the phone, is he really having that conversation...needless to say, it pretty well incapsitates him becasue he works construction and can't physically handle the materials/power tools safely and mentaly feels like crap.

    We have never found anyone that could explain what is going on, and getting sent home from the ER with an explanation of - well the nerologist has never heard of full body loss of senstation and it has always come back before so just go home and wait cause it must all be in your head - is a little frustrating.

    We both acknowledge it could be some kind of dissotiative response but we have never found any references to it elsewhere, don't know how to help him manage the response, don't know why it would have started manifesting itself in this way for the last 6 years when this never occured during the previous 10 years of therapy/recovery or the 17 years before that when he was still trapped in an abusive home...

    Anyone ever expereince this before?

  2. #2
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    Re: loss of tactile sensation?!?

    Though it may likely be psychosomatic, has thyroid disease been ruled out? http://www.doctorslounge.com/neurolo...opic-5947.html

    Another reason to rule out thyroid disease is that thyroid disease can cause depression or anxiety.

    Quote Originally Posted by childshe
    First occurance was about 6 yrs ago after he got a cracked mercury filing replaced - we went to a specialist because of the mercury released during the removal, the procedure involved some big dental damn, and suction hoses and a rather impatient/ramy dentist - my husband definately experienced a trauma response back to childhood sex abuse while in the chair...but when he started to go numb that night our focus was all on the possibility of mercury poisoning.
    Regarding mercury poisoning as the possible cause, it seems unlikely:
    Despite group differences in mercury levels, we found no statistically significant differences in measures of memory, attention, visuomotor function, or nerve conduction velocities...In summary, this trial showed that children treated with dental amalgam did not, over a 7-year follow-up period, demonstrate statistically significant differences in neurobehavioral and neurological test results compared with similar children treated with other dental materials.

    Neurobehavioral Effects of Dental Amalgam in Children (JAMA, 2006)
    Last edited by Daniel; May 6th, 2007 at 02:52 PM. Reason: Automerged Doublepost

  3. #3
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    Re: Loss of tactile sensation

    Quote Originally Posted by childshe
    my husband definately experienced a trauma response back to childhood sex abuse while in the chair...
    Quote Originally Posted by childshe
    don't know why it would have started manifesting itself in this way for the last 6 years when this never occured during the previous 10 years of therapy/recovery or the 17 years before that when he was still trapped in an abusive home...
    The following explanation seems very telling:
    Between 10 and 30% of patients seen by neurologists have symptoms for which there is no current pathophysiological explanation...In many patients a history of trauma, a stressful life event, or an "unspeakable dilemma" can be identified. Often functional [unexplained neurological] disorders seem to be sparked off by a relatively small event which appears to serve as a symbolic reminder of more serious trauma or distress in the past. Even if the identified problem does not seem serious enough to trigger a disabling functional symptom, it may be useful in engaging patients in psychological treatment. Functional symptoms in neurology: questions and answers (2005)

  4. #4
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    Re: Loss of tactile sensation

    Quote Originally Posted by childshe
    We both acknowledge it could be some kind of dissotiative response but we have never found any references to it elsewhere...
    I found a number of (mostly outdated) references to something called hysterical anesthesia, which is defined as:
    loss of tactile sensation occurring as a symptom of conversion disorder, often recognizable by its lack of correspondence with nerve distributions. Dorlands Medical Dictionary
    However, it's usually the case with so-called hysterical anesthesia that only part or half of the body is involved. I only found one reference to full body (general) anesthesia. It appears in an classic work by Pierre Janet:
    Although it does not happen so frequently, anesthesias may invade the whole surface of the body and suppress more or less completely such or such system of sensations.
    The Mental state of hystericals: A Study of Mental Stigmata and Mental Accidents By Pierre Janet (1901)(PDF)
    Additional info:
    Pseudosensory Syndromes

    Pseudosensory syndromes are common pseudoneurologic presentations. Patients with pseudosensory syndromes complain mainly of numbness (anesthesia). Symptoms often follow the patients' own concept of their anatomy. All sensory modalities (touch, pain, vibration, proprioception) disappear at a discrete border (joint or skin crease or midline), unlike true sensory loss where overlapping borders and different borders exist for the various sensory modalities.

    One common pseudosensory presentation is hemisensory loss with a nonphysiologic midline sensory split including genitals, hearing, vision, smell and taste, but sparing the back. True hemianesthesia does not split the genitalia because of overlapping innervation.

    Several bedside tests may be useful. First, the clinician may observe that painful stimuli applied to a "numb" extremity often increase the pulse rate by 20 to 30 beats per minute: a normal finding. In addition, unexpected painful stimuli may result in withdrawal of the "numb" extremity. Second, the clinician may try the tuning fork test by applying a tuning fork to a bony structure covering a hollow cavity. Vibratory loss on one half of the skull, sternum or pelvis is thought to be physiologically impossible because of bone conduction. The presence of vibratory loss over these surfaces suggests a pseudosensory syndrome.

    A third test is the Bowlus and Currier test. In this test, the patient's arms are extended and crossed with thumbs down and palms facing together. The fingers are then interlocked and the hands rotated downward, inward and up in front of the chest. The fingertips end up on the same side of the body as their respective arms. The thumbs are not interlocked so that they lie on the side opposite the fingers. With true sensory impairment, a patient can quickly identify fingers with normal and abnormal sensation when rapid sharp tactile stimuli are applied. Patients with pseudosensory deficits confuse the lateralization, causing them to make many mistakes identifying digits when sharp stimuli are applied to them.

    Another useful test is the "yes-no" test. When testing the sensation of touch, have patients close their eyes and give "yes" responses when they perceive they are being touched and "no" responses when they perceive that they do not feel a touch. A repeated "no" response when a supposedly numb limb is touched favors a pseudosensory syndrome.

    Finally, the clinician may test proprioception of the big toe. Patients with pseudosensory syndromes may erroneously identify the position of the big toe 100 percent of the time. In contrast, a rate of at least 50 percent accuracy would be anticipated with an organic lesion based purely on chance.

    In cases where it is difficult to discern the organicity of sensory loss, somatosensory evoked responses also may be useful.

    Pseudoneurologic Syndromes: Recognition and Diagnosis (1988)

  5. #5
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    Re: Loss of tactile sensation

    Daniel - Thanks so much for all the links and excerpts. It is comforting to see the formal definitions and names - reading my huband a few articles on pseudosensory syndrome and conversion disorder may not make the symptoms go away but at least it lets him know he is not alone in his reaction.

    We also finally made it to the top of a waiting list for a family doctor, so we should be ale to get some basic tests done to rule out anything organic.

    We will keep ploding along with relaxation and guided imagry techniques, continued therapy etc...

    Again, thanks for the support

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