CONGENITAL INSENSITIVITY TO PAIN - A 20-YEAR FOLLOW-UP

The exact nosological status of ''congenital insensitivity to pain'' r emains in doubt. Possible pathological correlates of this clinical syn drome include sensory neuropathy, central lesions at the level of the reticular formation or dorsal horn of the spinal cord, or a central in difference to, or asymbolia for, pain. The reassessment of two members of a kindred previously reported more than 20 years ago as having con genital insensitivity to pain indicated that they in fact had an inher ited sensory and autonomic neuropathy. Prolonged follow up and morphom etric analysis of sequential nerve biopsies may be necessary to defini tively establish this diagnosis.