Pain, Phantom Limb
Phantom limb pain refers to pain in two situations. In the first, a limb has been amputated accidentally or surgically, and the person continues to feel as though some or all the nonexistent limb is still present and hurting. In the second, most frequent when the living limb is largely denervated, the person feels as though the limb is in a different position from that of the actual structure. This occurs with denervation by injury to enough peripheral nerves, with avulsion of the nerve rootlets from the cord as in major brachial plexus injuries, with total transverse lesions of the entire cord in paraplegics, and finally, but much less often, with thalamic lesions. The manifestations in the two situations are different, and this discussion is confined to the first group who have had actual amputation. Ambroise Paré described “a thing wondrous strange and prodigious . . . patients who have many months after the cutting away of the leg, grievously complained that they yet felt exceeding great pain of that leg.” Although nearly 100% of amputees have sensations referred to the missing limb, there is gross disagreement on the percentage who have frank pain.
KeywordsPhantom Limb Phantom Limb Pain Thalamic Lesion Root Entry Zone Phantom Pain
- White JC, Sweet WH (1969): Pain and the Neurosurgeon: A Forty Year Experience. Springfield: Charles C Thomas, pp 68–86Google Scholar