Congenital analgesia and the danger of never feeling pain
Have you ever imagined being injured and yet feeling no pain? Although it may seem like some kind of superpower worthy of a fictional movie, this condition is real - and can also be very dangerous.
When the body does not recognize pain
There are many cases that have gained space in the media because the protagonist of the story did not feel any kind of pain. It was like this with a Brazilian woman, some years ago, who underwent a c-section without anesthesia and, in another moment, even fell asleep while giving birth to her second child.
Doctor Keila Galvão, neurologist from Hospital Anchieta in Brasília, explains that congenital analgesia is "the indifference or absence of physical pain". Thus, in the presence of a painful stimulus, the person can simply ignore it completely or even feel the pain, but without distinguishing the limit between the normal and the harmful.
This is an important alteration, since pain is essential for the protection of the human being, because it functions as a warning that something is wrong in the body. In this way, this insensitivity can lead to serious health problems.
The good news is that congenital analgesia is among the rarest diseases in the world: "It is a rare condition, with few cases described in the medical literature and confirmed genetically," says Keila. To have an idea, only 40 to 50 people present this condition.
However, according to the neurologist, "there are more complex conditions or syndromes that can bring pain analgesia as just one more symptom. It is then worth consulting a doctor to evaluate the situation, especially when it comes to children.
Causes and symptoms of congenital analgesia
According to Keila, the cause most associated with congenital analgesia is a mutation of the SCN9A gene on chromosome 2q24.3. In other words, it is a genetic variation in the central nervous system that prevents the communication of pain sensation to the brain.
The main symptom is, in fact, the absence of physical pain in the face of any injury, which happens from birth and accompanies the individual for the rest of his life. A baby can then suffer scratches or cuts and not complain, for example: "Children with bitten lips or cheeks, trauma from falls or fractures, injuries and loss of fingertips or teeth in children, inflammation orThe child cries due to emotional symptoms, but not because of pain", explains the doctor, recommending a lot of caution for parents and caregivers, who must be alert to signs that indicate that the child does not feel pain. In addition, irritability and hyperactivity may be associated with congenital analgesia.
Diagnosis and treatment
The diagnosis of congenital analgesia is made from the parents' complaints, neurological exams and genetic evaluation. The specialist requests a single gene when the clinical picture is compatible with a specific gene or with a multigene panel, covering all major known genes.
As for the treatment, Keila informs that it is based on multidisciplinary care involving nursing, occupational therapy, school, parents and caregivers. The pathology, unfortunately, has no cure and can present high risks for the carrier, such as corneal injury, tongue biting, localized or disseminated infections, joint deformities as a result of multiple traumas,burns, loss of teeth, and amputations.
The safety recommendations include frequent checking for injuries and the use of foot, ankle and elbow protectors during activities that can bring risk.more prone to infection), immobilize injuries to facilitate healing, because the child does not feel pain and will be exposed to trauma again", concludes the doctor.
Source: Dr. Keila Galvão, neurologist at Hospital Anchieta in Brasília.