Nociception in the context of "Coma"

Leprosy, also known as Hansen's disease (HD), is a long-term infection by the bacteria Mycobacterium leprae or Mycobacterium lepromatosis. Infection can lead to damage of the nerves, respiratory tract, skin, and eyes. This nerve damage may result in the loss of nociception, which can lead to the loss of parts of a person's extremities from repeated injuries or infection through unnoticed wounds. An infected person may also experience muscle weakness and loss of eyesight. Leprosy symptoms may begin within one year or take 20 years or more.

Leprosy is spread between people, although extensive contact is necessary. Leprosy has a low pathogenicity, and 95% of people who contract or who are exposed to M. leprae do not develop the disease. Spread is likely through a cough or contact with fluid from the nose of a person infected by leprosy. Genetic factors and baseline immune function play a role in how easily a person catches the disease. Leprosy is not spread during pregnancy to the unborn child or through sexual contact. Leprosy occurs more commonly among people living in poverty. There are two main types of the disease—paucibacillary and multibacillary, which differ in the number of bacteria present. A person with paucibacillary disease has five or fewer poorly pigmented, numb skin patches, while a person with multibacillary disease has more than five skin patches. The diagnosis is confirmed by finding acid-fast bacilli in a biopsy of the skin.

A hallucination is a perception in the absence of an external context stimulus that has the compelling sense of reality. They are distinguishable from several related phenomena, such as dreaming (REM sleep), which does not involve wakefulness; pseudohallucination, which does not mimic real perception, and is accurately perceived as unreal; illusion, which involves distorted or misinterpreted real perception; and mental imagery, which does not mimic real perception, and is under voluntary control. Hallucinations also differ from "delusional perceptions", in which a correctly sensed and interpreted stimulus (i.e., a real perception) is given some additional significance.

Hallucinations can occur in any sensory modality—visual, auditory, olfactory, gustatory, tactile, proprioceptive, equilibrioceptive, nociceptive, thermoceptive and chronoceptive. Hallucinations are referred to as multimodal if multiple sensory modalities occur.

A noxious stimulus is a stimulus strong enough to threaten the body's integrity (i.e. cause damage to tissue). Noxious stimulation induces peripheral afferents responsible for transducing pain (including A-delta and C- nerve fibers, as well as free nerve endings) throughout the nervous system of an organism.

The ability to perceive noxious stimuli is a prerequisite for nociception, which itself is a prerequisite for nociceptive pain. A noxious stimulus has been seen to drive nocifensive behavioral responses, which are responses to noxious or painful stimuli. These include reflexive, escape behaviors, to avoid harm to an organism's body.

In medicine and anatomy, the special senses are the senses that have specialized organs devoted to them:

• vision (the eye)
• hearing and balance (the ear, which includes the auditory system and vestibular system)
• smell (the nose)
• taste (the tongue)

The distinction between special and general senses is used to classify nerve fibers running to and from the central nervous system – information from special senses is carried in special somatic afferents and special visceral afferents. In contrast, the other sense, touch, is a somatic sense which does not have a specialized organ but comes from all over the body, most noticeably the skin but also the internal organs (viscera). Touch includes mechanoreception (pressure, vibration and proprioception), pain (nociception) and heat (thermoception), and such information is carried in general somatic afferents and general visceral afferents.

The anterior commissure (also known as the precommissure) is a white matter tract (a bundle of axons) connecting the two temporal lobes of the cerebral hemispheres across the midline, and placed in front of the columns of the fornix. In all but five species of mammal the great majority of fibers connecting the two hemispheres travel through the corpus callosum, which in humans and all non-monotremes is more than 10 times larger than the anterior commissure. Other routes of communication pass through the hippocampal commissure or, indirectly, via subcortical connections. Nevertheless, the anterior commissure is a significant pathway that can be clearly distinguished in the brains of all mammals.

The anterior commissure plays a key role in pain sensation, more specifically sharp, acute pain. It also contains decussating fibers from the olfactory tracts, vital for the sense of smell and chemoreception. The anterior commissure works with the posterior commissure to link the two cerebral hemispheres of the brain and also interconnects the amygdalae and temporal lobes, contributing to the role of memory, emotion, speech and hearing. It also is involved in olfaction, instinct, and sexual behavior.

A nociceptor (from Latin nocere 'to harm or hurt'; is a sensory neuron that responds to damaging or potentially damaging stimuli by sending "possible threat" signals to the spinal cord and the brain. The brain creates the sensation of pain to direct attention to the body part, so the threat can be mitigated; this process is called nociception.

Whether invertebrates can feel pain is a contentious issue. Although there are numerous definitions of pain, almost all involve two key components. First, nociception is required. This is the ability to detect noxious stimuli which evokes a reflex response that moves the entire animal, or the affected part of its body, away from the source of the stimulus. The concept of nociception does not necessarily imply any adverse, subjective feeling; it is a reflex action. The second component is the experience of "pain" itself, or suffering—i.e., the internal, emotional interpretation of the nociceptive experience. Pain is therefore a private, emotional experience. Pain cannot be directly measured in other animals, including other humans; responses to putatively painful stimuli can be measured, but not the experience itself. To address this problem when assessing the capacity of other species to experience pain, argument-by-analogy is used. This is based on the principle that if a non-human animal's responses to stimuli are similar to those of humans, it is likely to have had an analogous experience. It has been argued that if a pin is stuck in a chimpanzee's finger and they rapidly withdraw their hand, then argument-by-analogy implies that like humans, they felt pain. It has been questioned why the inference does not then follow that a cockroach experiences pain when it writhes after being stuck with a pin. This argument-by-analogy approach to the concept of pain in invertebrates has been followed by others.

The ability to experience nociception has been subject to natural selection and offers the advantage of reducing further harm to the organism. While it might be expected therefore that nociception is widespread and robust, nociception varies across species. For example, the chemical capsaicin is commonly used as a noxious stimulus in experiments with mammals; however, the African naked mole-rat, Heterocephalus glaber, an unusual rodent species that lacks pain-related neuropeptides (e.g., substance P) in cutaneous sensory fibres, shows a unique and remarkable lack of pain-related behaviours to acid and capsaicin. Similarly, capsaicin triggers nociceptors in some invertebrates, but this substance is not noxious to Drosophila melanogaster (the common fruit fly).Criteria that may indicate a potential for experiencing pain include: