Phantom limb pain

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By K K Jain MD

Phantom limb pain is also known as or subsumes Deafferentation pain. -ed.

“Phantom limb” is a term used to designate the sensation of the presence of an extremity following its amputation, which may be painful. In this clinical article, Dr. K K Jain, a neurology consultant in Basel, Switzerland, discusses the pathogenesis and strategies for prevention and treatment of phantom limb pain. Although it is possible to reduce the incidence of phantom limb pain through proper management after amputation, most of the drugs used for treatment are not effective. Among surgical procedures, deep brain stimulation has been reported to have some success.

Key points

  • Loss of a limb is followed by phantom limb phenomena that may be both painful and nonpainful.
  • Although there is no consensus on the pathomechanism of phantom limb pain, a strong relationship has been reported between the magnitude of the phantom limb pain and the amount of cortical reorganization.
  • A wide variety of methods--pharmacological, nonpharmacological and surgical--have been used for the management of phantom limb pan.
  • There is no entirely satisfactory treatment, but phantom limb pain can be prevented or partially reversed by adequate analgesic use in the peroperative period associated with limb amputation.