hiperesthesia

Hyperesthesia is an abnormal increase in the sensitivity of the senses, most often referring to heightened touch sensitivity. It can involve other modalities such as temperature or pain. Hyperesthesia is distinct from allodynia, which is pain produced by stimuli that normally do not provoke pain, though allodynia can occur in the setting of hyperesthesia. It can be localized to a nerve distribution or generalized and may be accompanied by paresthesias or dysesthesias.

Causes are diverse and include peripheral nerve injury or neuropathy (trauma, diabetes mellitus, alcohol-related neuropathy, vitamin deficiencies), infections (herpes zoster, postherpetic neuralgia), inflammatory or autoimmune disorders (vasculitis, lupus), central nervous system lesions (multiple sclerosis, spinal cord injury), complex regional pain syndrome, and exposure to certain toxins or medications (chemotherapy-induced neuropathy).

Clinically, patients report heightened sensitivity to light touch, pressure, temperature, or motion; symptoms may be described as burning, aching, tingling, or itching. Hyperesthesia must be distinguished from hyperalgesia (increased pain from a painful stimulus) and from simple allodynia. Evaluation focuses on distribution, onset, and associated neurological findings.

Diagnosis is primarily clinical, supported by history and examination, with testing used to exclude other conditions. Nerve conduction studies and electromyography can assess nerve function, while quantitative sensory testing and imaging may be used when a structural lesion is suspected. Laboratory tests may identify metabolic or inflammatory causes.

Treatment targets the underlying cause and symptom control. Pharmacologic options for neuropathic hyperesthesia include anticonvulsants (gabapentin, pregabalin), antidepressants (duloxetine, amitriptyline), and topical agents (lidocaine, capsaicin). Nonpharmacologic approaches include physical therapy, desensitization techniques, and psychological support. Prognosis varies with etiology; some cases improve with treatment, while others persist.