Phantom limb pain is experienced by nearly 50 - 80% of the patients following limb amputation. The anterior cingulate cortex (ACC) is a part of the limbic system that is an essential component in mediating the affective and emotional component of pain responses. To explore the role of ACC in the phantom limb pain, we recorded evoked excitatory postsynaptic potentials (EPSPs), cortical network a...

Educating patients about their condition is regarded as a fundamental step in pain management. This study used focus groups with patients to explore their experiences and perceptions of the information on phantom pain that they received before and after amputation, and their views on improving this information. Thirty-one patients with a lower limb amputation attended one of seven focus groups....

Six patients with chronic phantom tooth pain were studied for the presence of reference fields for their phantom sensation. In five of them, pain or dysesthesia in the affected oral structures was elicited by thermal or mechanical stimulation of areas that were well separate from these structures. However, a relation of topographical proximity between the stimulated areas and the areas of refer...

Almost all patients who undergo amputation suffer 'phantom sensations', a sensory perception of the missing limb, possibly caused by a neural imprint or memory of the limb within the brain. The patient may experience abnormal kinaesthetic sensation, such as the feeling that the limb is in an abnormal position. Perceived changes in length, size or temperature of the limb are also common. Some of...

Supernumerary phantom limb (SPL) resulting from spinal cord lesions are very rare, with only sporadic and brief descriptions in the literature. Furthermore, the reported cases of SPL typically occurred in neurologically incomplete spinal cord patients. Here, we report a rare case of SPL with phantom limb pain that occurred after traumatic spinal cord injury in a neurologically complete patient....

There are pathophysiological, clinical, and treatment analogies between phantom limb pain and phantom sound (i.e., tinnitus). Phantom limb pain commonly is absent in dreams, and the question arises whether this is also the case for tinnitus. A questionnaire was given to 78 consecutive tinnitus patients seen at a specialized tinnitus clinic. Seventy-six patients remembered their dreams and of th...

Postamputation phantom sensations and phantom pain, i.e., sensation or pain in the amputated limb, can be extremely distressing for people who have had amputations. Recent research on treating phantom phenomena has used the experimental induction of illusory body experiences. Although the suggestion has been that such experiences may influence the cortical remapping that occurs after amputation...

Home-based patient-delivered mirror therapy is a promising approach in the treatment of phantom limb pain. Previous studies and case reports of mirror therapy have used a therapist-guided, structured protocol of exercises. No case report has described treatment for either upper or lower limb phantom pain by using home-based patient-delivered mirror therapy. The success of this case demonstrates...

Phantom breast syndrome is a type of condition in which patients have a sensation of residual breast tissue and can include both non-painful sensations as well as phantom breast pain. The incidence varies in different studies, ranging from approximately 30% to as high as 80% of patients after mastectomy. It seriously affects quality of life through the combined impact of physical disability and...

© Copyright 2011 Elsevier Inc., Ltd., BV. All rights reserved. EPIDEMIOLOGY OF CHRONIC PAIN AFTER SURGERY The incidence of CPSP varies significantly by site of surgical procedure (Table 35-1); however, most reports support an incidence of at least 10% of patients having pain 1 year after surgery. Several high-quality reviews since the 1990s have highlighted the problem of chronic pain after sur...