Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Phantom Limb”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2000

Electroconvulsive therapy for phantom limb pain.

Phantom limb pain is common in amputees. Although several treatments are available, a significant number of patients are refractory. Electroconvulsive therapy (ECT), which is usually given to patients with psychiatric disorders such as major depression, has shown efficacy in patients with a variety of pain syndromes occurring along with depression. Two patients are described herein with severe phantom limb pain refractory to multiple therapies, without concurrent psychiatric disorder, who received ECT. Both patients enjoyed substantial pain relief. In one case, phantom pain was still in remission 3.5 years after ECT. It is concluded that phantom limb patients who are refractory to multiple therapies may respond to ECT.

Aged↗
PubMed2001

Caring for patients with phantom limb sensation.

Phantom limb pain is increasingly perceived as a complex condition that is likely to have multifactorial causes. Although acknowledgement of the existence of the condition is more prevalent than it was, its treatment remains elusive. Nurses caring for people with phantom limb pain have a unique role to play in the overall holistic therapy of the amputee.

Female↗
PubMed2000

Phantom limb pain in the human brain: unraveling neural circuitries of phantom limb sensations using positron emission tomography.

Pain and other phantom limb (PL) sensations have been proposed to be generated in the brain and to be reflected in activation of specific neural circuits. To test this hypothesis, hypnosis was used as a cognitive tool to alternate between the sensation of PL movement and pain in 8 amputees. Brain activity was measured using positron emission tomography. PL movement and pain were represented by a propagation of neuronal activity within the corresponding sensorimotor and pain-processing networks. The sensation of movement was significantly (corrected for multiple comparisons) related to activity in the supplementary motor area and the primary sensorimotor cortex. The sensation of a painful PL posture activated the same brain areas but was weaker and less extended in the supplementary motor area. In contrast to the sensation of movement, pain was significantly related to activity in the thalamus, anterior cingulate, and lateral prefrontal cortex. Subjectively rated PL pain sensation correlated positively to activations in the anterior and posterior cingulate. These findings provide evidence that PL sensations are produced by the same central nervous processes that underlie the experience of the body when it is intact and that the corporeal awareness of PL pain is encoded in a thalamocortical network.

Adult↗
PubMedDate not supplied

Phantom limb pain.

Phantom limb pain is a common sequel to amputation, whether traumatic or surgical. Provision of a pain-free interval before surgery is likely to reduce the incidence of the condition. The possible mechanisms of pain perception in an absent body part and the reasons for the frequent failure of conventional therapy are discussed here.

Amputation Stumps↗
PubMedDate not supplied

Phantom limb sensation.

1. Phantom limb pain and sensations are common in amputees. The present paper defines phantom limb pain, stump pain and phantom limb sensation and then gives an overview of the incidence and characteristics of the phenomena. 2. Theories of phantoms are presented, including peripheral, central and supraspinal theories, with particular attention given to Melzack's neuromatrix. 3. Evidence of cortical reorganization following amputation is given and the extent to which cortical reorganization contributes to phantom limb pain is discussed.

Amputation, Surgical↗
PubMed2001

Increased excitability in the primary motor cortex and supplementary motor area in patients with phantom limb pain after upper limb amputation.

Using functional magnetic resonance imaging and single slice FLASH technique, we investigated reorganization of the hand representation of the primary sensorimotor cortex (SMC) in 16 patients with upper extremity amputation. Patients were asked to perform finger tapping with the intact hand, repetitive eye closing and anteflexion of the amputation stump or intact shoulder. Six normal volunteers served as control. In the normal volunteers activations during shoulder anteflexion, finger tapping and eye closure were located within the central sulcus in a medio-lateral fashion. Patients demonstrated invasion of the face or shoulder representation into the hand representation of the amputated limb. Eight phantom limb pain patients showed significantly greater activation in SMC and supplementary motor area (SMA) in contrast to eight patients without phantom limb pain. We conclude, that different parts of the motor system are affected in patients with phantom limb pain--possibly in the sense of an up-regulation of excitability.

Adolescent↗
PubMedDate not supplied

Phantom limb pain.

A phantom limb is universally experienced after a limb has been amputated or its sensory roots have been destroyed. A complete break of the spinal cord also often leads to a phantom body below the level of the break. Furthermore, phantom breasts, genitals and other body areas occur in a substantial number of people after surgical removal or denervation of the body part. The most astonishing feature of a phantom limb (or other body area) is its incredible "reality" to the person. An examination of phantom limb phenomena has led to a new theory. It is proposed that we are born with a widespread neural network--the "neuromatrix"--for the body-self, which is subsequently modified by experience. The neuromatrix imparts a pattern--the "neurosignature"--on all inputs from the body, so that experiences of one's own body have a quality of self and are imbued with affective tone and cognitive meaning. The theory is presented with supporting evidence as well as implications for research.

Humans↗
PubMedDate not supplied

Noise-driven neuroplasticity in self-organizing feature maps: a neurocomputational model of phantom limbs.

The term "phantom limb" denotes the sensation that an extremity is present although it has been lost. A number of clinical features and recent findings of cortical map plasticity after destruction of afferent pathways (deafferentation) suggest that phantom limbs are caused by large-scale cortical reorganization processes. However, in paraplegics, who also suffer from cortical deafferentation, phantom sensations rarely develop, and if they do, they are weak, lacking in detail, and delayed, occurring after months. This has been taken to suggest a non-cortical genesis of phantom limbs. This article proposes a biologically plausible minimal neural network model to solve this apparent puzzle. Deafferentation was simulated in trained self-organizing feature maps. Reorganization was found to be directed by input noise. According to the model, the production of input noise by the deafferented primary sensory neuron promotes cortical reorganization in amputees. No such noise is generated or conducted to the cortex in paraplegics.

Amputation, Surgical↗
PubMed1987

Phantom limb pain. A review.

Phantom limb pain, which affects a majority of amputees, must be distinguished from phantom limb sensation, a universal consequence of limb amputation. Although the characteristics and time course of phantom limb pain are well described in the literature, no single theoretical approach can fully account for the contradictory aspects of this condition, thus its underlying mechanisms remain unclear. Theories concerning the etiology of phantom limb pain categorized as peripheral, central and psychological have given rise to a myriad of treatment approaches.

Amputation Stumps↗
PubMed2001

Phantom limb pain and residual limb pain following lower limb amputation: a descriptive analysis.

PURPOSE: This research aimed to develop a clearer picture of the experience of residual limb pain and phantom limb pain following a lower limb amputation and to gain a greater understanding of their relationships with physical and psychosocial variables. METHOD: One hundred and four participants completed the Trinity Amputation and Prosthesis Experience Scales (TAPES), which includes a section on each of, psychosocial issues, activity restriction, satisfaction with a prosthesis and pain (incidence, duration, level and extent of interference). RESULTS: The results showed that 48.1% of the sample experienced residual limb pain and 69.2% experienced phantom limb pain. While fewer people experienced residual limb pain, those who did, experienced it for longer periods, at a greater level of intensity and with a greater amount of interference in their daily lifestyle, than people who were experiencing phantom limb pain. The experience of residual limb pain was associated with other medical problems and low levels of Adjustment to Limitation. Phantom limb pain was associated with older age, being female, above knee amputation, causes other than congenital causes, not receiving support prior to the amputation, the experience of other medical problems, low scores on Adjustment to Limitation and high scores on Aesthetic Satisfaction with the prosthesis. CONCLUSION: These findings provide a greater understanding of the issues to be taken into consideration in the rehabilitation of people with a lower limb amputation.

Adolescent↗
PubMed1989

Experiences of phantom limb sensations in dreams.

Phantom limb sensations in the waking state and in dreams were examined in 84 limb-amputated patients. These phenomena were divided into complete, reduced, intermittent and nonexisting phantom limb. Common features as well as differences between the phantom limb in the waking state and in dreams were characterized and illustrated by casuistics and dream reports. Thus it was shown that nearly half the patients had the same, whereas the others had a different phantom limb in the waking state and in dreams.

Aged↗
PubMed1979

Phantom limb and multiple sclerosis.

Phantom limb phenomena are most often associated with amputations, although they may accompany many neurologic disorders. In the neurologic variety, expression of illusory limbs varies with the level at which the somesthetic pathway is interrupted, and with changes in consciousness. Phantom limb illusions are rarely reported in patients with multiple sclerosis (MS). The patient reported here complained of a supernumerary phantom limb during an exacerbation of MS. This case suggests that in neurologic diseases, phantom limb illusions may result from distorted perception of limbs that are subject to both sensory loss and such recurrent spontaneous sensations as paresthesias.

Adult↗
PubMed2004

P300-amplitudes in upper limb amputees with and without phantom limb pain in a visual oddball paradigm.

The aim of the study was to investigate to what extent cortical hyper-reactivity to visual stimuli is present in upper limb amputees. Five amputees with phantom limb pain (PLP), five amputees without PLP (Non-PLP) and 10 healthy controls (HC) were investigated using a visual oddball paradigm. Two hundred visual stimuli were presented with target stimuli occurring at a probability of 25% and standard stimuli at a probability of 75%. Event-related potentials were recorded from nine scalp positions (F3, F4, Fz, C3, C4, Cz, P3, P4, Pz). The PLP-patients had significantly higher P300-amplitudes to both types of stimuli compared to the non-PLP-patients. The HC were not significantly different from both amputee groups. P300-amplitude to targets at frontal sites in the hemisphere contralateral to the amputation was higher in the PLP patients. P300-latencies to target stimuli differed only at frontal sites with PLP-patients showing significantly longer latencies than non-PLP-patients. To standard stimuli, however, they showed significantly shorter latencies at central and parietal scalp positions. The HC had significantly shorter latencies than both amputee groups. The size of the P300-amplitude was positively correlated with the intensity of PLP. These findings suggest a higher magnitude of non-specific cortical excitability in amputees with PLP and a reduced excitability in amputees without PLP. This extends previous findings of differences in cortical excitability in PLP and non-PLP patients in the sensorimotor domain.

Adult↗
PubMed1999

Phantom limb pain: a review of the literature on attributes and potential mechanisms.

This study presents a review of the literature on the attributes and potential mechanisms involved in phantom limb pain, encompassing studies describing pain in the residual limb, phantom sensation and phantom limb pain, and the difficulties that may arise when making these distinctions. A variety of theories have been proposed to explain causal mechanisms for phantom limb pain. Conceptually, research into phantom limb pain is informed by the particular theory of chronic pain that is dominant at the time the research is undertaken. For example, early physiological theories on the etiology of phantom limb pain were grounded in specificity or pattern theories of pain. Later physiological research was based on the framework provided by Gate Control Theory and focused on identifying peripheral, spinal, and central neural mechanisms. Psychological explanations were grounded in psychoanalytic or personality theories of chronic pain which propose that phantom limb pain results from pre-amputation psychological disturbance. Despite numerous studies examining phantom limb pain, much of this research has both conceptual and methodological shortcomings. As such, the application of these research findings to clinical practice has limited utility.

Amputation Stumps↗
PubMed1982

Phantom limb: a phenomenological study.

Phantom limb phenomena during the post-operative period were studied in 72 amputees. All were right handed. Phantom limb was present in 86.1 per cent of the cases, significantly more commonly amputation of the right arm. Nearly half of the phantoms developed within the first 24 hours and another quarter in the next 24 hours, appearing earlier in lower limb amputees. Movements in the phantom were felt by three-quarters of the cases, an incidence unaffected by site or side of amputation. Telescopy was present in nearly two-thirds and phantom limb pain in over two-thirds, significantly more commonly in the upper limb amputees but uninfluenced by the side of amputation. Thirty-one of the patients dreamed that their limbs were intact.

Adolescent↗