Have you ever wondered what life would be like without physical pain? Would life be
more peaceful? Would we be more aggressive or would we possibly be incapable of enjoying the
pleasures of life? We may think we are better off without pain but “Pain is simply our intrinsic
medical adviser to warn us and stimulate us” (H.G. Wells, The Island of Dr. Moreau). Some
people have been able to experience this anomaly, the ability to be incapable of experiencing any
physical pain. These people are proven examples that pain is in fact necessary. Without pain one
can never truly discover their body’s physical limits and may against their knowledge inflict a
great deal of pain upon themselves.
People with the inability to feel pain have the disease called Congenital Insensitivity to
Pain with Anhidrosis (CIPA). CIPA is categorized as a Hereditary Sensory and Autonomic
Neuropathic disease. Congenital Insensitivity to pain is the inability to feel uneasy sensations
pertaining to an individual from birth. Anhidrosis is the inability to sweat thus causing the
incapability to regulate body temperature.
HSAN type IV is a genetic disorder caused by multiple DNA mutations. These mutations
occur on the neuropathic tyrosine kinase receptor types one (ntrk1 gene). In normal people the
NGR (neuropathic gene receptor) stimulates the growth support and the survival of the
autonomic sympathetic neurons as well as nociceptive sensory neurons, which transmit pain
sensations to the spinal cord and the brain. Mutations occur in portions of the gene that encode
the intracellular and extracellular domain of the protein, which may affect the variability in
Hereditary Sensory and Autonomic Neuropathic (HSAN) type IV causes Congenital
Insensitivity to Pain with Anhidrosis. HSAN IV is the second most common type of HSAN.
CIPA symptoms normally manifest at an early age, but can be difficult to diagnose. Infants with
CIPA rarely cry from normal ailments, such as not crying when hungry as they cannot sense
hunger and they can sleep soundly throughout the night as they cannot sense their needs that
need to be met. Parents believe it to be a blessing that their child doesn’t cry until other onset
symptoms occur. These symptoms include unexplained fevers, self-mutilation, and
developmental delay. When teething children often chew on anything they can, but since
children with CIPA don’t realise the pain of biting themselves, teething becomes dangerous.
Many CIPA children begin to bite off their own tongue and fingers when teething; often ripping
out their own teeth as well. Around this time, parents begin to realise that these symptoms are
not normal for children.
People with CIPA can’t live a normal life because of the many unfortunate ailments
caused by the disease. Hyperactivity is a common characteristic of children with CIPA, as is
being unable to differentiate between temperatures. Many children die early because it is very
easy for them to overheat as they cannot regulate their own body temperature. The lack of
sweating causes the skin to become thick and susceptible to skin infections and cellulitis. Their
bones deteriorate over a shorter period of time than normal bones. Their joints are overused
usually confining patients to a wheelchair (wheelchair bound). An infinite number of patients
develop appendicitis and die because they are unable to feel the pain that this would normally
cause. It is impossible to determine the number of CIPA patients, as there is quite a discrepancy
in the statistics.
Unfortunately, there is no cure for CIPA, and they are very few treatment options. Since
it is a rare disorder there hasn’t been a lot of research done on the topic. To regulate the body
temperature, some individuals with CIPA...
Bibliography: Axelrod, F.B., von Simson, G. G., Oddoux, C. (2008, August 5). Hereditary Sensory and
Autonomic Neuropathy IV
Brown, A. (2006, May 20). It’s not so easy being a superhero. The Gazette. Retrieved December
1, 2008, from http://findarticles.com/p/articles/mi_qn4191/is_20060520/ai_n16434313.
Lambert, K. (n.d). How CIPA Works. How Stuff Works. Retrieved November 12, 2008, from
Lee, B. (2008, November 17). Health Talk: Congenital insensitivity to pain. The Tartan.
Retrieved December 2, 2008, from
Wells, H. G. (1988). The Island of Dr. Moreau. New York: Signet Classic.
Please join StudyMode to read the full document