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Paraesthesiae from ectopic impulse generation in human sensory nerves.

J L Ochoa, H E Torebjörk

    Brain : a Journal of Neurology
    |December 1, 1980
    PubMed
    Summary

    Abnormal nerve activity causes tingling sensations after blood flow is restored. Ectopic impulses from myelinated nerve fibers, not skin receptors, create these altered perceptions.

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    Area of Science:

    • Neuroscience
    • Physiology
    • Clinical Neurology

    Background:

    • Post-ischaemic paraesthesia, commonly known as tingling or pins and needles, is a frequent sensory disturbance following temporary interruption of blood flow.
    • The precise neurophysiological mechanisms underlying these sensations, particularly the origin and nature of abnormal nerve activity, remain incompletely understood.

    Purpose of the Study:

    • To investigate the electrophysiological basis of spontaneous nerve activity during post-ischaemic paraesthesiae in humans.
    • To determine the origin of ectopic impulses and their relationship to the perceived sensory disturbances.

    Main Methods:

    • Intraneural microelectrode recordings were performed on sensory nerve fascicles in awake subjects experiencing post-ischaemic paraesthesiae.
    • Stimulation techniques, including hyperventilation and repeated ischaemic periods, were employed to modulate nerve activity.
    • Local anaesthetic blocks were utilized to differentiate between receptor-mediated and nerve-fibre-generated activity.

    Main Results:

    • Spontaneous afferent fibre activity commenced shortly after circulation re-establishment, peaking within minutes and correlating with paraesthesia intensity.
    • During intense paraesthesiae, single unit discharges featured high-frequency, prolonged bursts originating ectopically along previously ischaemic nerve fibres.
    • Myelinated fibres exhibited paroxysmal discharges, while unmyelinated fibres showed normal activity, suggesting their involvement in the abnormal sensations.

    Conclusions:

    • Post-ischaemic paraesthesiae are generated by ectopic impulses arising from damaged myelinated nerve fibres, not peripheral receptors.
    • The abnormal spatio-temporal pattern of these ectopic discharges from various sensory units creates a chaotic perceptual experience.
    • Understanding these mechanisms may inform therapeutic strategies for managing neuropathic pain and sensory disturbances.

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