Hüperesteesia

Hüperesteesia, also known as hyperesthesia, is a neurological symptom defined by an abnormally increased sensitivity to sensory stimuli. It may involve tactile, thermal, or proprioceptive modalities and can be localized to a small area or region, or be more widespread.

In clinical terms, hyperesthesia differs from paresthesia, which is a non-specific abnormal sensation such as tingling, and from allodynia and hyperalgesia, which describe pain-related phenomena: allodynia is pain from normally non-painful stimuli, while hyperalgesia is an exaggerated pain response to painful stimuli.

Causes include peripheral nerve injury or neuropathy (for example, diabetic neuropathy or postherpetic neuralgia), nerve compression, inflammatory or infectious processes, stroke or spinal cord lesions, and certain central nervous system disorders. It may appear after surgery, trauma, or in association with conditions such as complex regional pain syndrome or multiple sclerosis.

Evaluation involves a neurologic examination with sensory testing (light touch, pinprick, temperature, vibration, and proprioception), sometimes quantitative sensory testing, and assessment for other neurologic signs. Diagnostic workup is guided by the clinical picture and may include imaging and laboratory tests to identify an underlying cause.

Treatment focuses on addressing the underlying condition and managing symptoms. Options include pharmacologic therapies for neuropathic pain such as gabapentinoids (gabapentin, pregabalin), antidepressants (SNRIs like duloxetine, TCAs), and topical agents (lidocaine, capsaicin). Desensitization therapies, physical therapy, and, in refractory cases, nerve blocks or neuromodulation may be considered. The prognosis depends on the cause and response to treatment.