Asymbolia for Pain

CLINICAL neurologists have observed patients who do not react to painful stimuli and yet have no anesthesia. Some of these patients, instead of withdrawing, will sometimes actually proffer their limbs for the pinprick. In such a case an inexperienced examiner when carrying out a routine sensory examination might note that pain sensation was normal, inasmuch as the patient could distinguish between sharp and dull equally throughout the body. Or, on the contrary, he might report that there was generalized hypesthesia when the patient stated that the pinprick did not hurt. Asymbolia for pain denotes the inability to recognize the unpleasant or disagreeable component of a painful or threatening stimulus, with the result that little or no defense reaction is produced, although the noxious stimulus itself is perceived. Although related to apraxia, it is characterized by the fact that it is a type of apraxia only in this distinctive sphere of