Altered Pain Perception in a Young Adult with Childhood Trauma and Suspected Riley-Day Syndrome: A Case Report

  1. Martínez-Lozano, Pedro 15
  2. Sousa-Pitti, Maurcio 1
  3. Toro-Pérez, Natalia 1
  4. Cuenca-Zaldívar, Juan Nicolás 1234
  5. Cid-Verdejo, Rosana 189
  6. Martínez-Pozas, Oliver 16
  7. Jiménez-Ortega, Laura 101112
  8. Sánchez-Romero, Eleuterio A. 1367
  1. 1 Interdisciplinary Research Group on Musculoskeletal Disorders, Calle Agustín Querol 5, 28014 Madrid, Spain
  2. 2 Grupo de Investigación en Fisioterapia y Dolor, Departamento de Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
  3. 3 Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), 28222 Majadahonda, Spain
  4. 4 Physical Therapy Unit, Primary Health Care Center “El Abajón”, 28231 Las Rozas de Madrid, Spain
  5. 5 Department of Physiotherapy, Faculty of Medicine, Health and Sports, Universidad Europea de Madrid, Calle Tajo, s/n, Urb. El Bosque, 28670 Madrid, Spain
  6. 6 Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
  7. 7 Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL 33965, USA
  8. 8 Faculty of Dentistry, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain
  9. 9 Department of Clinical Dentistry, Faculty of Biomedical Sciences, Universidad Europea de Madrid, Plaza de Francisco Morano s/n, 28670 Madrid, Spain
  10. 10 Department of Psychobiology, Complutense University of Madrid (UCM), 28040 Madrid, Spain
  11. 11 Center for Human Evolution and Behavior, Instituto de Salud Carlos III (ISCIII), Complutense University of Madrid (UCM), 28029 Madrid, Spain
  12. 12 Psychology and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
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Journal:
Reports

ISSN: 2571-841X

Year of publication: 2025

Volume: 8

Issue: 2

Pages: 80

Type: Article

DOI: 10.3390/REPORTS8020080 GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Reports

Abstract

Background and Clinical Significance: Altered pain perception is a diagnostic challenge for patients with a history of trauma and substance use. Familial dysautonomia (Riley-Day syndrome) may further complicate the sensory profiles. Case Presentation: We describe a male in his late twenties, originally from Central America, with a history of severe childhood trauma and chronic cannabis use, who reported diminished pain perception despite multiple injuries. Despite the absence of nociceptive pain (nociceptive hypoesthesia), abnormal sensations, such as tingling and itching (paresthesia), and occasionally unpleasant burning sensations (dysesthesia) were common symptoms in this case. Diagnosis: Clinical suspicion of familial dysautonomia was raised based on altered pain perception and minor autonomic signs. However, no genetic testing or neurological evaluation was performed. Psychological assessment revealed high levels of neuroticism, depression, and maladaptive coping. The Central Sensitization Inventory (CSI) and the Symptom Severity Scale (SS) further supported the presence of psychological symptoms suggestive of possible central sensitization. Outcome: Functional improvement was observed after a reduction in substance use and implementation of self-directed physical and cognitive rehabilitation. No standardized follow-up or formal interventions were recorded. Conclusions: This case illustrates the complexity of pain modulation in trauma-affected individuals and emphasizes the need for an integrative, interdisciplinary evaluation of atypical pain presentations.

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Funders

  • Interdisciplinary Research Group on Musculoskeletal Disorders

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