Phantom Limb Syndrome(Phantom Pain; Phantom Limb; Neuropathic Pain)by Dianne Scheinberg, MS, RD, LDN DefinitionPhantom limb syndrome is the perception of sensations, usually including pain, in a limb that has been amputated. Patients with this condition experience the limb as if it were still attached to their body as the brain continues to receive messages from nerves that originally carried impulses from the missing limb. Nervous System Copyright © Nucleus Medical Media, Inc. CausesThe exact cause of of phantom limb syndrome is unknown. Presumably, the sensations are due to the brain’s attempt to reorganize sensory information following the amputation. The brain must essentially “rewire itself” to adjust to the body change. Risk FactorsThe following factors increase the chance of developing phantom limb syndrome:
SymptomsSymptoms occur in people who have had a limb removed and people who are born without a limb. The symptoms are perceived in a limb that does not exist. Symptoms include:
DiagnosisFollowing an amputation, it is important to tell your doctor if you experience pain or other sensations. Earlier treatment generally improves the chances of success. There is no medical test to diagnose phantom pain. Your doctor will take a medical history, do a physical exam, and especially want to know about the signs, symptoms, and circumstances that occurred before and after the removal of the limb. TreatmentFortunately, most cases of phantom limb following amputation are brief and infrequent. For those patients who suffer from persistent pain, treatment can be challenging. MedicationsSelected medications used to treat phantom limb pain include:
Electrical Nerve StimulationIn some cases, electrical nerve stimulation may be used. Examples include:
Other Approaches
PreventionTo help reduce your chances of getting phantom limb syndrome, some believe that administering pain medication at the time of the amputation may prevent persistent pain afterward. The effectiveness of this approach has yet to be confirmed. Amputee Coalition of America Amputee Resource Foundation of America Amputee Resources National Institute of Neurological Disorders and Stroke Amputee.ca The War Amps Carlson N. Physiology of Behavior . Boston, MA: Allyn and Bacon; 1998. Flor H, Nikolajsen L, Jensen TS. Phantom limb pain: a case of maladaptive CNS plasticity? Nature Reviews Neuroscience . 2006;7:873-881. Phantom pain. Mayo Clinic website. Available at: http://www.mayoclinic.com . Accessed August 5, 2005. Sekuler R, Blake R. Perception . 4th ed. NewYork: McGraw-Hill Inc.; 1994. Last reviewed November 2012 by Rimas Lukas, MD |
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