Imagine the frustration of a child who cringes at the feeling of clothing against their skin or the anxiety that comes from the startling loudness of everyday noises. For parents and caregivers of children on the autism spectrum, this scenario is all too familiar. And there is a name for it – hyperesthesia.
Hyperesthesia is a sensory processing challenge prevalent in individuals with autism that makes their senses super strong, making things that are normally okay feel really intense and hard to deal with. Hyperesthesia is thus defined by heightened sensory experience in any of the five senses causing pain stimulation.
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Recent studies have shown that hyperesthesia syndrome is often caused by pain (neuropathic pain) caused by damage or disease in the somatosensory nervous system. The somatosensory nervous system is the part of the nervous system that deals with the conscious perception of touch, pressure, temperature, etc. Neuropathic pain has various symptoms expressed differently across different people.
The two most common forms of hyperesthesia are allodynia and hyperalgesia.
- Allodynia is the pain sensation of a stimulus that doesn’t usually hurt. For example, you feel pain when washing your face or sitting on a chair.
- Hyperalgesia is an exaggerated pain that would normally not be as severe in other individuals.
The unusual heightened sensibility can occur in any of the senses, i.e., touch, sound, sight, and smell. If only one of the five senses is heightened, a specific name for that type of hyperesthesia is assigned — for example, tactile hyperesthesia, auditory hyperesthesia, and so on…
The different types of hyperesthesia include:
- Tactile (touch) sensitivity
- Optic (sight) sensitivity
- Auditory (sound) sensitivity
- Gustatory (taste) sensitivity
- Olfactory (smell) sensitivity
The increased sensitivity in any of these senses may cause pain in the affected sense.
Research has shown that most symptoms due to hyperesthesia are hallucinatory — meaning that a person with auditory hyperesthesia may experience pain to a sound that isn’t there.
Hyperesthesia in Autism
One of the symptoms of autism spectrum disorder (ASD) under the DSM-5 is sensory sensitivity, such as hypersensitivity or hyposensitivity to sensory input.
This is in addition to unusual responsive reactions to sensory input, such as indifference to temperature, unfavorable response to specific sounds or textures, excessive smelling or touching of objects, and visual fascination with lights or movement.
From this criteria, the sensory experience of autistic individuals can be heightened sensibility to sensory stimuli, which describes the experience of hyperesthesia. Since autism is a spectrum, these experiences can vary in sensibility in different senses.
The research is inconclusive on the link between hyperesthesia and autism, but some recent studies have suggested a link. Parents should seek a qualified neurologist’s help to confirm a hyperesthesia diagnosis.
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Causes of Hyperesthesia
Since hyperesthesia is caused by the sensory nerves in the peripheral nervous system, including the peripheral nerve that runs outside our brain and spinal cord, if this nerve is damaged (peripheral neuropathy), it may cause the hyperesthesia experience. In severe cases, this condition can affect the nervous system, lead to nerve inflammation, and possibly seizures.
Other possible causes include:
- Too much caffeine: Recent research suggests drinking too much coffee or caffeine can lead to temporary hyperesthesia lasting 3-5 hours.
- Compression of a nerve: Studies have shown that when a nerve is under pressure, meaning pinched or compressed, the function of that nerve is affected. This might cause hyperesthesia.
- Viral infection: Whilst not conclusive in its findings, recent studies have indicated a link between hyperesthesia and a viral infection like Covid-19. Many viral infections have been known to attack peripheral nerves.
Symptoms of Hyperesthesia
As explained before, hyperesthesia comes in different forms, especially for individuals on the autism spectrum. However, according to the National Library of Medicine, common symptoms can include:
- Weakness in muscles
- Pain or being very sensitive to touch
- Numbness or even a lack of feeling
- Tingling or a burning sensation
Here are a few suggestions of treatment options if your autistic child has symptoms of hyperesthesia.
Cognitive behavioral therapy (CBT)
- Cognitive behavioral therapy is a psychological treatment method that has been proven effective in improving individuals’ quality of life and functioning by changing thinking patterns and reevaluating people’s reality vs. psychological experience.
- To treat hyperesthesia, a training technique known as sensory retraining could help individuals who suffer from hyperesthesia.
- Sensory retraining helps the person with a nerve injury or abnormal sensory reaction to learn how to interpret the neural impulse when the altered sensory experience is stimulated.
Pain management specialist
- A pain management specialist curates treatment plans specific to clients; this care depends on the type of pain the patient experiences.
- A psychiatrist with training in Interventional Pain Management (IPM) is a type of specialist with training in treating pain-related disorders. The goal of this specialist is to help relieve, reduce, or manage pain so that the person can function optimally without needing medication or surgery.
- Occupational therapy aims to help regulate the child’s sensory experience through physical activities.
- A technique that an occupational therapist can introduce is sensory integration therapy (SIT). SIT can help the child integrate and respond to his/her sensory experience more appropriately by stimulating the sensory stimuli in a structured and repetitive pattern. The idea behind this is so that the brain adapts and, in return, the child responds to it more efficiently.
- A neurologist is a medical doctor specializing in treating conditions affecting the nervous system. The nervous system (NS) consists of the central NS and the peripheral NS. The latter is part of the NS that is shown to be affected in hyperesthesia and other sensory disorders.
- Consulting with a neurologist is possibly the first step in seeking a diagnosis of any nerve-related conditions or abnormalities.
FAQs About Hyperesthesia in Autism
Q: How common is hyperesthesia in individuals with autism?
A: There are no official statistics on Hyperesthesia in autism, but it is estimated that 7-8% of people within the general population suffer from neuropathic pain.
Q: Can hyperesthesia improve over time?
A: With appropriate support and strategies, many individuals experience improvements in managing hyperesthesia.
Q: Are there any medications to treat hyperesthesia?
A: While there are no specific medications for hyperesthesia, some individuals may benefit from the strategies mentioned above that focus on sensory integration.
Q: What role does early intervention play in managing hyperesthesia?
Early intervention is crucial. Identifying and addressing sensory sensitivities early can lead to more effective coping strategies and a better quality of life.
Q: How can I find a sensory-friendly therapist for my child?
A: Contact local autism organizations or ask for recommendations from your child’s school or healthcare provider.
Hyperesthesia is a form of sensory abnormality that could possibly be linked to autism, but due to the lack of research to support this, its relationship is a hypothesis.
The sensory experience of hyperesthesia and autism are similar, but in hyperesthesia, that sensibility leads to pain in the affected area. Parents with children on the spectrum who suspect their child has a sensory abnormality should consult a medical doctor or specialist to receive an accurate diagnosis of hyperesthesia.