At Allesthesia Do the patients not perceive touches, temperature stimuli or pain stimuli on the irritated area, but assign them to another part of the body. The cause is often a parietal lobe lesion, such as can trigger a cerebral infarction. Physical therapy training can bring about an improvement.
The cause of generalesthesia is a cerebral lesion, which is usually in the cerebral cortex.
Allesthesia is a neurological change in perception that goes back to brain lesions and has disease value. It belongs to the so-called asomatognosias, in which the perception of one's own body changes pathologically. In generalesthesia, sensory stimuli such as pain, cold or touch are no longer in the correct part of the body.
There are different subforms of universalesthesia. With the visual and acoustic form, the patient no longer perceives visual or acoustic stimuli in the right direction. The allesthesia is also called allachesthesia, alloesthesia or allochiria. It differs from psychological perception disorders in that there is primarily a physical cause for the misperceptions.
Allesthesias are often associated with other phenomena from the group of asomatognosia, for example with anosognosia or anosodiaphories. Sensory disorders such as hyperesthesia, hypesthesia or dysesthesia are similar to allesthesia. The physiological phenomenon of alliesthesia must be distinguished from allesthesia.
The cause of generalesthesia is a cerebral lesion, which is usually in the cerebral cortex. Possible locations are the inferior parietal lobe, the interparietal sulcus and the supramarginal gyrus or the angular gyrus. These areas of the brain regulate the sphere of body feeling and thus assign perceptions to a specific part of the body.
Various Brodmann areas are located here. They play a role in the perception of one's own body in space and thus also in movement planning. The brain regions mentioned analyze where things are in space and also track objects on the skin. The motor plans of the brain regions are carried out through connections to the frontal lobe.
A lesion in these areas is often preceded by a cerebral infarction or stroke in the corresponding area. The pathological change in perception occurs somewhat less often as part of an inflammatory reaction, as it is caused in the central nervous system, for example, in multiple sclerosis. Visual allesthesia can also be caused by an occipital lobe lesion or epilepsy and migraines. Tumors are rarely responsible for allesthesia.
The symptoms of generalesthesia differ depending on the subtype. Tactile allesthesia shift the conscious perception of a touch, a temperature stimulus or a pain sensation to another part of the body. So those affected do not feel the tactile stimuli on the actually stimulated area. With acoustic allesthesia, on the other hand, directional hearing is disturbed.
Visual allesthesia causes visual illusions and apparently shifts objects within the field of vision from one half of the field of vision to the opposite. If the cause of the generalesthesia is damage to the parietal lobe, then neurological accompanying symptoms usually occur. Dizziness and disorientation can be part of it, for example.
This applies above all to visual general aesthetics, in which the vertigo symptoms are caused by the shifted field of vision. Because of the causal damage in the brain, more or less severe headaches can occur.
The doctor receives the first suspicion of an allesthesia in the anmanesis and during various sensation tests. The diagnosis primarily requires evidence of causal lesions in the brain. If there are no such physical causes, then instead of generalesthesia there is presumably a psychologically conditioned perception disorder.
Mentally caused misperceptions must therefore be excluded in the context of differential diagnostics. The detection of brain lesions is provided by imaging the brain, for example by means of an MRI with contrast agent administration. In generalesthesia, the course of the disease depends primarily on the cause. Stroke-related general aesthetics can often be largely eliminated through training, especially in young patients.
Various complications can occur with generalesthesia. This is due to the nature of the disease. Stimuli are not perceived at the location of the stimulus, but at a different location. This means that the stimuli are located incorrectly. Because of this, the response to the stimulus cannot be adequate. If, for example, there is tactile general aesthetics, it can happen that a pain stimulus is perceived in the wrong place. Assume that the patient burns his left thumb on a stove, but perceives the stimulus, i.e. the pain, in his right thumb.
So he will first pay attention to his right thumb and look for the cause of the pain at this point before he notices the burn on his left thumb. The reaction to the external stimuli may therefore not take place adequately with allesthesia. This fact can lead to some complications, as the actually affected parts of the body are exposed to the stimulus longer.
Of course, this occurs not only on pain stimuli but also on all other stimuli. It is therefore of great importance to learn to deal with the allesthesia and to achieve a correction of the sensations via senses that are not affected by the allesthesia. The mentioned complication is only to be seen as an example; various other complications, some of which are similar, can occur in the everyday life of the patient.
A doctor should be consulted immediately if generalesthesia is suspected. The sensation of pain cannot be assigned to any direct cause in everyday life. Because of this, there is a risk of not classifying them correctly. It is made more difficult because the pain stimuli take place at a location other than where the stimulus was applied. This misleading approach can lead to an incorrect assessment of the current situation.
Waiting or hesitation is not recommended for generalesthesia. Since the cause of generalesthesia is brain damage, the signs and symptoms are difficult for non-medical professionals to interpret and classify. Those affected often mistakenly assume that the symptoms are temporary. Unfortunately, this is not the case.It is therefore important to seek medical advice as quickly as possible and to use test procedures to determine the cause.
Often the generalesthesia is preceded by a disease such as a cerebral infarction or a stroke. For this reason, an unpleasant sensation of stimulus in a place other than the stimulus is often assigned as an after or side effect of the previous illness or medication. This incorrectly causes a time delay to see a doctor again.
Allesthesia can be associated with irreversible brain damage. Even if this does not necessarily have to lead to a total failure of a system, it is advisable to clarify the damage in good time.
The therapy of allesthesia mainly corresponds to a causal therapy of the primary disease. For example, causative tumors are removed as much as possible. In the case of allesthesia in the context of multiple sclerosis or various types of epilepsy, causal therapy is not fully possible. The diseases can be controlled relatively well through the administration of drugs such as immunosuppressants and neuroleptics.
For some time now, physiotherapy for correcting sensations has also been suggested for the treatment of allesthesia. As part of these therapies, sensory systems or brain regions that are not impaired and therefore still fully functional are trained and made to take over the tasks of damaged areas. Such compensations have long been known from stroke therapy and are often crowned with success.
Even if brain regions were irreversibly damaged in the context of general aesthesia, the patient does not necessarily have to live with a permanent perception disorder. At least improvements in symptoms can often be achieved through the therapies. The patient's will and willingness to work are probably the most decisive influencing factors for success in learning compensations.
For the prognosis of the course of the disease, additional circumstances are initially of great importance. Some general aesthetics, for example, are so inhibiting that patients avoid doctor contact with their complaints. Without appropriate treatment, however, no improvement in the condition can be brought about in generalesthesia. Spontaneous healing initiated by the organism, as is the case with conventional wounds, cannot occur in a brain lesion.
For a prognosis of the further course of the disease it is important to determine the severity of the existing brain lesion. Above all, it is important to have a quick diagnosis and subsequent therapeutic measures in order to rule out any further deterioration in the condition.
Complete recovery is not to be expected with generalesthesia, which is why the course of the disease must be expected for an indefinite period. For a more accurate prognosis, the focus must first be on the cause of the disease. It can be between various causes. This can result in further therapy options that alleviate the course of the disease.
For example, after the removal of brain tumors, the prognosis of the course of the disease must be reassessed, since the removal can lead to both an improvement and a worsening of the condition.
The further course of the disease is often very dependent on the patient's behavior. In this way, incorrect stimuli and perceptions can be reduced by treating the patient with medication and physiotherapy. In the long term, this results in a much better prognosis than the lack of adequate treatment of the clinical picture.
Allesthesia can be prevented to a certain extent, depending on the cause. At least strokes can be prevented with a healthy lifestyle, early recognition of the stroke risk and appropriate prophylaxis with a relatively good chance of success.
Everyday help and self-help are an important element of an overall therapeutic concept in the case of all-aesthetic sensory disorders, which also includes physiotherapeutic measures. The incorrectly localized pain sensations or other haptic or even optical impressions are mostly based on damage to certain regions in the brain.
Similar to strokes, there is often the chance that the sensory disturbances can be compensated for by constant and consistent practice in other regions of the brain. It takes a little patience to achieve corrective improvement in the localization of sensations with carefully designed exercises. It is advisable to put the exercises together with a physiotherapist experienced in the field. If possible, self-help should be accompanied by moderate exercise, active relaxation exercises and a balanced and varied diet. This ensures that circulatory disorders and an inadequate supply of important micronutrients do not stand in the way of the success of physiotherapeutic exercises.
If the generalesthesia mainly affects incorrectly localized pain perception, additional attention training helps to mentally direct the pain perception to the “right place” in order to pull the affected part of the body out of the danger zone as quickly as possible. If, for example, heat pain occurs on the right thumb, which actually affects the left thumb, attention can be trained in such a way that it is recognized with only a short delay that the left thumb is actually affected and must be removed from the danger zone.