Chronic anxiety dysesthesia is a rare disease that typically causes hyperesthesia, paresthesia or peripheral sensory neuropathy. Dysesthesia can simply be described as a burning sensation that is worse where touch sensation is poorest. It may be associated with chronic anxiety. Because chronic anxiety dysesthesia is a diagnosis of exclusion, inquiring about symptoms or history that may be consistent with other disorders is important. Symptoms suggestive of other underlying conditions include fatigue, hot flashes, irregular periods, vaginal dryness, mood swings, irritability, weight loss or gain, skin and nail changes, heartburn, polyuria, polydipsia, numbness or tingling in any other area of the body, neurologic symptoms, fevers, lymphadenopathy, cough, shortness of breath, or lightheadedness. It can also be due to lesions or an abnormal change in sensory nerves and sensory pathways in the central nervous system.
People who experience chronic anxiety dysesthesia have facial numbness and various tingling on different parts of their body. They may likewise have a temporary loss of vision and feel a heavy fatigue along with a spastic bladder. Dysesthesia due to a lesion in the PNS usually occurs below the level of the lesion. Some of its common causes may be in a broad spectrum of diseases, disorders and medications. Sufferers may be feeling an abnormal nervousness most of the time and without cause.
Chronic anxiety is now considered an association or an exacerbating factor in the chronic picture of dysesthesia. Cases of spontaneous resolution of symptoms after positive life events have been reported. Patients with dysesthesia may also have increased salivary cortisol relative to controls, indicative of higher level of stress. A proportion of patients have anxiety centered around concerns of cancer or cancerphobia. At this point, the nature of the association between dysesthesia and chronic anxiety is not clear.
The history in the patient with chronic anxiety dysesthesia is extremely important. First of all, as with most neurologic complaints, one must determine what the patient means by “dysesthesia.” Some patients are describing loss of sensitivity or numbness (anesthesia or hypesthesia) or distorted sensations (paresthesia), which is often described as tingling. Actual loss of sensitivity is more likely to represent true damage to sensory pathways in the nervous system, while paresthesia has a much broader differential. Dysesthesia, that is the perception of an unpleasant (often burning) sensation or allodynia (the perception of innocuous stimuli as being painful) may result from damage to the nervous system or, more commonly, be the manifestation of an underlying painful condition. That is, signs or symptoms of chronic anxiety dysesthesia that would lead to other conditions such as stroke or multiple sclerosis exacerbation should be properly diagnosed.
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