Is seeing believing? Functional imaging of hysterical anesthesia
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The CNS can be viewed as a system that processes information received from peripheral afferents and that sends the results of the processing through motor and other efferent systems. Movements and physiologic measurements readily evaluate the function of the efferent output system. Evaluation of the afferent input system is considerably more complex. The function of the afferent systems can be inferred from physiologic measurements, but, in most cases, the only true indicator is an individual’s description of a private, subjective experience.
In the clinic, the patient’s descriptions of sensory abnormalities are often puzzling. Pain or the loss of sensation frequently crosses the boundaries of peripheral nerves. Sensory abnormalities that do not respect the borders of established dermatomes frequently lead clinicians to consider a psychological cause for the patient’s symptoms.
What has been puzzling in terms of dermatomes is now explicable by spinal physiology. In the case of pain, it is now clear that classic dermatomes do not provide the only neurobiological map. Once the peripheral nerves have entered the spinal cord via nerve roots, …
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