[Interaction between the systems involved in fast pain perception and in slow, persistent pain (author's transl)]

(2. Wechselwirkungen zwischen dem System der schnellen Schmerzempfindung und dem des langsamen, nachhaltigen Schmerzgefühls)

Full Abstract

A single pinprick triggers both a pang, the "1st pain" and after a pause of 0.5 s, a spreading burning feeling, the "2nd pain". The 2nd pain is delayed because it is conducted by unmyelinated C-fibers at a rate of less than 1 m/s, 20 times slower than conduction of the 1st pain. In the spino-thalamic tract the myelinated fibers of the 1st pain conduct much faster than those of the 2nd pain, and terminate in the parvocellular ventroposterior (VP) thalamic nucleus, which projects to area 3b in the postcentral gyrus. The slow C-fibers of the 2nd pain terminate in cortex-independent thalamic nuclei like limitans, which project to the outer segment of the pallidum. This subcortical pain pathway is disinhibited after destruction of the cortical pathway of the 1st pain, so that the patients suffer from spontaneous agonizing pain feeling (thalamic pain). Unbearable pain in cases of thalamic softening, in anaesthesia dolorosa and in phantom pain can be relieved by stereotactic coagulation of the thalamic nuclei involved in the 2nd pain. Normally they are inhibited by the cortical pathway of the 1st pain.

Author information

Author/s: Hassler, R (R);

Journal and publication information

Publication Type: English Abstract; Journal Article

Journal: Langenbecks Archiv für Chirurgie (Langenbecks Arch Chir), published in GERMANY, WEST. (Language: ger)

Reference: 1976-Nov; vol 342 (issue ) : pp 47-61

Dates: Created 1977/01/29; Completed 1977/01/29; Revised 2006/11/15;

PMID: 792594, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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