Congenital Insensitivity to Pain without Anhidrosis: Orodental Problems and Management

N Abdullah,A R Samsudin,Kausar Sadia Fakhruddin

doi:10.1155/2015/179892

Abstract

This paper reports the case of a 4-year-old male patient who was brought by parents requesting for replacement of multiple missing anterior teeth. The patient suffered from congenital insensitivity to pain without anhidrosis and presented with full blown sequelae of the condition in the form of oral self-mutilation leading to loss of teeth, tongue tip amputation, finger tips destruction, and lower limb wound infections. Dental and orthopaedic treatment consists of local management of oral wound and prevention from further oral and finger injuries that takes the form of dental splints and finger sleeve splints, constant feet coverage with shoes, and behavioural medical therapy. The age of the patient and parents' education present challenges in managing this condition to avoid morbidity and premature mortality.

Highlights

Pain is a common unpleasant experience often caused by intense or damaging stimuli
Despite protection from potential external harmful insults, the patient themselves self-mutilate their own body, chewing their own tongue, lips, and fingers destructively [4,5,6,7,8]. These cases are very often referred to dental clinics for emergency management of acute oral trauma resulting from their neurological condition. This case report describes a case of a four-year-old boy with congenital insensitivity to pain that was brought by his parents seeking dental help for prostheses to replace his self-extracted primary teeth at the University Dental Hospital Sharjah, United Arab Emirates
Patient’s right little toe got hurt while playing for which he obviously never complained, which later got infected leading to necroses and ultimate amputation (Figure 1). At this stage he was diagnosed as suffering from congenital insensitivity to pain without signs of anhidrosis

Summary

Introduction

Pain is a common unpleasant experience often caused by intense or damaging stimuli. Acquired insensitivity to pain such as diabetic neuropathy is a common condition. Despite protection from potential external harmful insults, the patient themselves self-mutilate their own body, chewing their own tongue, lips, and fingers destructively [4,5,6,7,8]. These cases are very often referred to dental clinics for emergency management of acute oral trauma resulting from their neurological condition. This case report describes a case of a four-year-old boy with congenital insensitivity to pain that was brought by his parents seeking dental help for prostheses to replace his self-extracted primary teeth at the University Dental Hospital Sharjah, United Arab Emirates

Case Presentation

Discussion