Phantom limb pain

1975 ◽  
Vol 42 (3) ◽  
pp. 301-307 ◽  
Author(s):  
Karl D. Nielson ◽  
John E. Adams ◽  
Yoshio Hosobuchi
Keyword(s):  
Phantom Limb Pain ◽  
Dorsal Column ◽  
Phantom Limb ◽  
Phantom Pain ◽  
Limb Pain ◽  
Content Type ◽  
Successful Series ◽  
Dorsal Column Stimulation ◽  
Fine Print

✓ Good to excellent relief of phantom pain is reported in 5 of 6 patients by the use of dorsal column stimulation. Follow-up periods are 7 to 25 months. One failure occurred despite excellent pain relief; this patient could not tolerate application of the DCS apparatus to his chest wall. The authors review the physiology involved and some less successful series reported by others.

Dorsal root entry zone lesions for post-amputation pain

1985 ◽  
Vol 62 (1) ◽  
pp. 72-76 ◽  
Author(s):  
Stephen C. Saris ◽  
Robert P. Iacono ◽  
Blaine S. Nashold
Keyword(s):  
Dorsal Root ◽  
Dorsal Column ◽  
Phantom Limb ◽  
Phantom Pain ◽  
Entry Zone ◽  
Dorsal Root Entry Zone ◽  
Content Type ◽  
Root Entry Zone ◽  
Stump Pain ◽  
Dorsal Column Stimulation

✓ Chronic pain following an amputation may involve the stump, the phantom limb, or both. Operations such as rhizotomy, cordotomy, stump revision, and dorsal column stimulation have been unsuccessful in treating this condition. This study evaluates the effectiveness of dorsal root entry zone (DREZ) coagulation for this pain problem. The authors studied 22 patients with amputations due to trauma, gangrene, or cancer. All developed post-amputation pain, underwent a DREZ procedure, and were followed from 6 months to 4 years after surgery. Overall, only eight (36%) of these 22 patients had pain relief. However, good results were obtained in six (67%) of nine patients with phantom pain alone, and in five (83%) of six patients with traumatic amputations associated with root avulsion. Poor results were obtained in patients with both phantom and stump pain, or stump pain alone. The DREZ procedure has a limited, but definite, place in the treatment of post-amputation pain.

Pain reduction in amputees by long-term spinal cord stimulation

1980 ◽  
Vol 52 (3) ◽  
pp. 346-350 ◽  
Author(s):  
Jörg-Ulrich Krainick ◽  
Uwe Thoden ◽  
Traugott Riechert
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Pain Reduction ◽  
Dorsal Column ◽  
Content Type ◽  
Follow Up Study ◽  
Dorsal Column Stimulation ◽  
Fine Print

✓ This follow-up study analyzes the results of dorsal column stimulation instituted between 1972 and 1974 for the relief of pain in 84 patients, including 64 amputees. Good results decreased from 52.4% after 2 years of stimulation to 39% after 5 years. Special therapeutic problems in amputees are discussed.

An Experimental Study of Atypical Phantom Pain

1965 ◽  
Vol 111 (481) ◽  
pp. 1185-1187 ◽  
Author(s):  
I. Pilowsky ◽  
A. Kaufman
Keyword(s):  
Experimental Study ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Phantom Pain ◽  
Limb Pain ◽  
Emotional Factors ◽  
Psychological Mechanism

A number of writers have drawn attention to the importance of emotional factors in phantom limb pain (Kolb, 1950, 1952; Simmel, 1956; Russell, 1959; Von Hagen, 1963). Kolb (1950, 1952) reported an association between the discussion of certain emotionally loaded topics and accesses of pain in the phantom. Stengel (1965), in his Maudsley Lecture, discussed the role played in these experiences by the psychological mechanism of identification with others. He briefly referred to the patient whom we have studied.

Preliminary percutaneous dorsal column stimulation prior to permanent implantation

1972 ◽  
Vol 37 (2) ◽  
pp. 242-245 ◽  
Author(s):  
Yoshio Hosobuchi ◽  
John E. Adams ◽  
Philip R. Weinstein
Keyword(s):  
Dorsal Column ◽  
Screening Procedure ◽  
Intractable Pain ◽  
Content Type ◽  
Dorsal Column Stimulation ◽  
Fine Print

✓ Percutaneous dorsal column stimulation was done as a screening procedure in 34 candidates before implantation of a permanent dorsal column stimulator for the treatment of intractable pain. This procedure was useful in forecasting the tolerance of the patient to the “vibratory sensation” produced by a dorsal column stimulator, and the efficacy of the device in relieving pain. Eight patients termed the “vibratory sensation” intolerable. Sixteen found it unpleasant but preferable to the pain, and two found it actually pleasant.

scholarly journals BCI training to move a virtual hand reduces phantom limb pain

Neurology ◽  
2020 ◽  
Vol 95 (4) ◽  
pp. e417-e426
Author(s):  
Takufumi Yanagisawa ◽  
Ryohei Fukuma ◽  
Ben Seymour ◽  
Masataka Tanaka ◽  
Koichi Hosomi ◽  
...  
Keyword(s):  
Crossover Trial ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Class Iii ◽  
Limb Pain ◽  
Virtual Hand ◽  
Before And After ◽  
Hand Image

ObjectiveTo determine whether training with a brain–computer interface (BCI) to control an image of a phantom hand, which moves based on cortical currents estimated from magnetoencephalographic signals, reduces phantom limb pain.MethodsTwelve patients with chronic phantom limb pain of the upper limb due to amputation or brachial plexus root avulsion participated in a randomized single-blinded crossover trial. Patients were trained to move the virtual hand image controlled by the BCI with a real decoder, which was constructed to classify intact hand movements from motor cortical currents, by moving their phantom hands for 3 days (“real training”). Pain was evaluated using a visual analogue scale (VAS) before and after training, and at follow-up for an additional 16 days. As a control, patients engaged in the training with the same hand image controlled by randomly changing values (“random training”). The 2 trainings were randomly assigned to the patients. This trial is registered at UMIN-CTR (UMIN000013608).ResultsVAS at day 4 was significantly reduced from the baseline after real training (mean [SD], 45.3 [24.2]–30.9 [20.6], 1/100 mm; p = 0.009 < 0.025), but not after random training (p = 0.047 > 0.025). Compared to VAS at day 1, VAS at days 4 and 8 was significantly reduced by 32% and 36%, respectively, after real training and was significantly lower than VAS after random training (p < 0.01).ConclusionThree-day training to move the hand images controlled by BCI significantly reduced pain for 1 week.Classification of evidenceThis study provides Class III evidence that BCI reduces phantom limb pain.

Distribution of activity in spinal pathways evoked by experimental dorsal column stimulation

1975 ◽  
Vol 42 (3) ◽  
pp. 290-295 ◽  
Author(s):  
Heinrich Bantli ◽  
James R. Bloedel ◽  
Donlin M. Long ◽  
Phudhiphorn Thienprasit
Keyword(s):  
Rhesus Monkeys ◽  
Dorsal Column ◽  
Electrode Position ◽  
Content Type ◽  
Spinal Pathways ◽  
Therapeutic Value ◽  
Stimulus Parameters ◽  
Different Characteristics ◽  
Dorsal Column Stimulation ◽  
Fine Print

✓ Experiments were performed in rhesus monkeys to determine the distribution of activity evoked in spinal pathways by dorsal column stimulation. It was shown that many pathways in both the dorsal and ventral quadrants of the cord can be activated either directly or transsynaptically by stimulation with electrodes of the type implanted clinically. Moreover, the transsynaptically evoked responses recorded in each quadrant had somewhat different characteristics. Therefore, since the activation of each group of pathways may have differing effects in modifying the perception of noxious stimuli, the authors believe that changes in electrode position and stimulus parameters may be important in obtaining the therapeutic value of spinal cord stimulation for relief of pain.

Phantom Limb Pain

2018 ◽  
Author(s):  
Kenneth D. Candido ◽  
Teresa M. Kusper ◽  
Alexei Lissounov ◽  
Nebojsa Nick Knezevic
Keyword(s):  
Alternative Therapy ◽  
Phantom Limb Pain ◽  
Body Part ◽  
Phantom Limb ◽  
Treatment Modalities ◽  
Phantom Pain ◽  
Limb Pain ◽  
Surgical Interventions ◽  
Neurologic Sequelae ◽  
The 19Th Century

Post-amputation pain (PAP) has challenged clinicians for centuries. The first written record of this perplexing condition came from the 16th-century French military surgeon Ambrose Paré. The term phantom limb pain (PLP) was coined by Silas Weir Mitchell, who provided a comprehensive description of the condition during the 19th century. Since that time, the understanding of PLP has greatly expanded; however, our knowledge of the exact mechanisms underlying it is still very deficient. Amputation of a body part can result in one sequela or more than one neurologic sequelae occurring concurrently: phantom sensation, phantom pain, and stump pain. The incidence and prevalence vary across the spectrum of these syndromes. A myriad of treatment modalities are employed in an attempt to terminate PLP, including pharmacotherapy, injections, alternative therapy, surgical interventions, and neuromodulation. Despite an extensive search for effective therapeutic options, PLP remains a highly challenging and debilitating condition.

Phantom Limb Pain Responds to Distant Skin Magnets: Support for the Functional Existence of Acupuncture Meridians

1998 ◽  
Vol 16 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Timö Töysä
Keyword(s):  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Leg Pain ◽  
Phantom Pain ◽  
Limb Pain ◽  
Stopping Treatment

Phantom leg pain in 10 patients was treated with skin magnets to the ipsilateral superior ends, on the thorax, of the leg Yin-meridians (KI.27, LR.14 and SP.21). The majority of patients reported relief of phantom pain while skin magnets were in situ, but in general this benefit was lost soon after stopping treatment. In two cases the method appeared more effective than morphine, and in a few patients it seemed to have some prophylactic benefit.

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