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Pijn door water: aquadynia bij DVN

Pijn door water: aquadynia bij dunnevezel neuropathie (DVN). Een zeer zeldzaam optredend symptoom: ernstige pijn bij het baden of douchen.

Onderzoekers en neurologen van de universiteit van Parma in Italië schreven het volgende over dit zeldzame symptoom:[1]

Aquadynia is a rare phenomenon of water-induced pain through presumed neural mechanisms. We describe two women in whom bathing was regularly followed by pain in the lower limbs, as a unique symptom (case 1) and, respectively, in the clinical context of an axonal polyneuropathy (case 2).

Hier hun eerste gevalsbeschrijving:

Case 1: A 71-year-old woman complained, by age 69, of pruritus and pinprick-like pain in the extremities that lasted about 20 minutes following bathing. Neurological examination and electroneurography were negative, as well as investigations for systemic diseases. Quantitative sensory testing (QST) showed abnormal cold-pain sensation. Treatment with gabapentin was not effective.

Hun visie is dat dit symptoom een manifestatie is van beschadiging van de dunne zenuwvezels: 

Aquadynia likely represents a manifestation of small fiber neuropathy. It is unclear whether it has to be viewed as a primary sensory phenomenon similar to allodynia, or a type of noradrenergic pain primarily due to autonomic dysfunction.  

Clonidine zou kunnen helpen.[2]

Sinds 2016 zetten we bij dit soort DNV klachten onze fenytoine 10% creme in.

Versie Oktober 2009; Auteurs: Prof.dr. Jan M. Keppel Hesselink en Drs David J. Kopsky, artsen, reviesie feb 2017, JMKH

Referentie

[1] Brindani, F., Gemignani, F. and Zinno, L. | Aquadynia. a manifestation of small fiber sensory neuropathy? | Journal of the peripheral nervous system | 9(2):119, June 2004.

[2] Rodríguez Cuartero A, Rodríguez Cuartero F. | [Myocardial infarct and hepatic cirrhosis]. | Rev Clin Esp. | 1976 Jun 15;141(5):461-4.

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