Two patients are presented with muscle spasms in an amputation stump. Neither patient experienced neuropathic pain nor phantom sensations, though phantom sensory phenomena, severe pain, and lack of response to treatment is characteristic of reported cases. One patient, a 75 year old man, has had myoclonic activity of the stump for more than two years, and the other, a 79 year old woman, recover...

INTRODUCTION We describe the case of a patient who experienced phantom pain that began 42 years after right above-the-knee amputation. Immediately prior to phantom pain onset, this long-term amputee had experienced, in rapid succession, cancer, hemicolectomy, chemotherapy, and thrombotic occlusion. Very little has been published to date on the association between chemotherapy and exacerbation o...

Previous studies have indicated that amputation or deafferentation of a limb induces functional changes in sensory (S1) and motor (M1) cortices, related to phantom limb pain. However, the extent of cortical reorganization after lower limb amputation in patients with nonpainful phantom phenomena remains uncertain. In this study, we combined functional magnetic resonance (fMRI) and diffusion tens...

OBJECTIVE To determine the frequency of phantom limb sensation (PLS) and phantom limb pain (PLP) in children and young adults suffering landmine-related amputation. MATERIALS & METHODS All youths with amputation due to landmine explosions participated in this study. The proportions of patients with phantom limb sensation/pain, intensity and frequency of pain were reported. Chi square test was...

Psychological distress and postamputation pain were investigated in a sample of 582 males with long-term limb amputations (mean time since amputation 639.3 months, standard deviation 166.1; range 240-784 months). Prevalence of significant depressive symptoms (Hospital Anxiety and Depression Scale [HADS]-D score > or = 8) was 32.0%, and 34.0% of respondents met the screening criterion for clinic...

BACKGROUND Pain after amputation is common but difficult to treat, and few controlled treatment studies exist. METHODS In the current study, 94 treatment-naive posttraumatic limb amputees with phantom pain (intensity: mean visual analog scale score [0-100], 40 [95% confidence interval, 38-41]) were randomly assigned to receive individually titrated doses of tramadol, placebo (double-blind com...

Postamputation pain (PAP) is highly prevalent after limb amputation but remains an extremely challenging pain condition to treat. A large part of its intractability stems from the myriad pathophysiological mechanisms. A state-of-art understanding of the pathophysiologic basis underlying postamputation phenomena can be broadly categorized in terms of supraspinal, spinal, and peripheral mechanism...

A variety of treatments have been historically used to alleviate phantom limb pain (PLP) with varying efficacy. Recently, virtual reality (VR) has been employed as a more sophisticated mirror therapy. Despite the advantages of VR over a conventional mirror, this approach has retained the use of the contralateral limb and is therefore restricted to unilateral amputees. Moreover, this strategy di...

Policy Aetna considers motor cortex stimulation experimental and investigational for the treatment of the following indications (not an all-inclusive list) because its effectiveness has not been established: Amyotrophic lateral sclerosis Chronic refractory pain (e.g., central pain syndromes, peripheral neuropathic pain, phantom limb pain, and trigeminal neuropathic pain) Dysphagia Dystonia seco...

P ERSISTENT pain after limb amputation is common, most often taking the form of phantom limb pain or localized pain in the residual portion of the limb (stump pain). The conflicts in Afghanistan and Iraq have brought this to the forefront: in a report appearing in 2008, of the 8,058 reported military casualties in US military personnel, 5,684 (70.5%) had major limb injuries; and 423 (7.4%) of p...