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Qualitatively, these seem reminiscent of the "lightning pains"
of neurosyphilis. These are most common in the areas of the body where the dysesthetic
burning is most common, yet are much more specific in their location.
Lancinating pains
tend to recur in the same area of the body, but occasional "outlier" shocks
occur. Even these "outliers" will be in the same body areas as the dysesthetic
burning. Occasionally, a patient may notice a slight fasciculation of the muscle at the
point of origination of the lancinating pain. Generally however, the physician will find
no fasciculation. The radiating pain may travel a few inches or a foot or more. Its
onset may feel like an insect bite, or it may resemble an electric shock. It is very
startling and harsh. It can be the most intense pain in the condition, but because Central
Pain patients are accustomed to "pain with no relief", its bizarre but
short-lived nature does not create the same fear as dysesthesia. It can occur in a range
of severities, from almost imperceptible to the approximate level of a wasp sting. The
lancinating pain has dysesthetic qualities, but is at the other end of the spectrum from
dysesthetic burning in that lancinating pain seems to convey very precise discriminative
(epicritic) information, although it is spontaneous. It may represent collateral discharge
from a spindle burst which finds its way to epicritic pathways.
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The Mnemonic of Central Pain