This is a picture from the Cuyahoga Falls Veterinary Clinic published here with their permission. Although the title to this article is about a picture of a cat suffering from feline hyperesthesia it is a picture, in fact, of self-mutilation which is a symptom or consequence of this mystifying disease. I think it has still got the veterinarians scratching their heads which is why they probably resort to drugs to suppress the symptoms. They can be quite successful.

A lot has been written about feline hyperesthesia. Apparently recent research indicates that it might be because of a problem with the electrical activity in the brain which controls predatory behaviour, grooming and emotions. I have not seen this study.
The word “hyperesthesia” means an increase in sensitivity which reflects the symptoms. If you touch a cat with this disease they act as though it is painful. Their skin seems to twitch as if they are irritated simply by the air currents passing over them. Some cats engage in self-mutilation with some attacking their tails or, in the cat in the picture, their necks. Comment: might not the cat in the picture be suffering from allergic dermatitis from a a flea collar and not feline hyperesthesia? I am not a vet. Just guessing.
Drug treatments
This leads me to a study on the Stage journals website in which retrospectively the scientists analysed seven cases of cats suffering from feline hyperesthesia syndrome and tail mutilation. They did a range of tests and found that MRI scans of the brain, spinal cord and cauda equina found no abnormalities. They also found that the cats did not suffer from Toxoplasma gondii or feline immunodeficiency virus. Neither were they suffering from feline leukaemia virus. Analysis of cerebrospinal fluid found no abnormalities. And finally, electro-diagnostic test did not reveal any clinical abnormalities.
You can see that is a bit mystifying. They used a variety of medications either singly or in combination to resolve the symptoms including gabapentin, meloxicam, antibiotics, phenobarbital, prednisolone, topiramate, cyclosporin, amitriptyline, tramadol, clomipramine, and flouxetine (prozac).
They found clinical improvement in six cases and in five cats there was complete remission of clinical signs. This was achieved with gabapentin by itself in two cases and in a combination of gabapentin/ciclosporin/amitriptyline in one case. And in the second case there was complete remission through the use of gabapentin/prednisolone/phenobarbital. In the third case the drugs worked when in combination using gabapentin/topiramate/meloxicam.
The scientists proposed further work specifically an “integrated multidisciplinary diagnostic pathway” to understand how better to manage these cases.
I have an article on this topic which I wrote some time ago. In the best reference book that I have on the subject there is very little information which supports the view that veterinarians are unsure about it. It appears to occur in cats in the age brackets 1-4. It is apparently more commonly seen in some purebred cats namely Siamese, Burmese, Himalayans and Abyssinians. They are not sure whether it is a neurological problem or a behavioural one.
As mentioned antiseizure medications, steroids and/or behaviour modifying medications are used to control it. If the cause is behavioural a programme of behaviour modifications may work.
The study referred to: Feline hyperaesthesia syndrome with self-trauma to the tail: retrospective study of seven cases and proposal for an integrated multidisciplinary diagnostic approach – Pablo Batle et al.