The central pain patient can usually differentiate cold burn from heat burn, but that may merely reflect the rudimentary or fragmentary retention of slight sensory discrimination when the stimulus is sufficiently strong. Similarly, the patient may not be able to differentiate texture from heat when the stimulus is lowgrade. For example, the patient may be able to distinguish a hot stove from sandpaper, but the suede inside shoe tongues, a texture stimulus, may simply feel like heat. This is a complicated situation and difficult for the patient to explain to the doctor. For unknown reasons, warm water and warm air are slower to evoke dysesthetic burning than cold air or cold water.
Physician asks whether patient ever feels pain in an area other than the area being stimulated.
Patient replies in the negative. Patients with CP have such poor localization they often are unaware of this kind of allodynia. Physician observes that patient looks normal and so does not ask about allodynia. Patients put their best foot forward when dealing with the medical profession. They often wear shoes or dress with more clothing than usual ,with consequent agony, to avoid offending the physician over a state of undress.