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Phantom limb pain

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https://www.readbyqxmd.com/read/28921474/origins-of-phantom-limb-pain
#1
Damien P Kuffler
Phantom limb pain (PLP) is a chronic neuropathic pain occurring in 45-85% of patients who undergo major amputations of the upper and lower extremities. Chronic pain is physically and mentally debilitating, affecting an individual's potential for self-care and the performance of daily living activities essential for personal and economic independence. In addition, chronic pain may lead to depression and feelings of hopelessness. A National Center for Biotechnology Information study found that in the USA alone, the annual cost of dealing with neuropathic pain is more than $600 billion, with an estimated 20 million people in the USA suffering this condition...
September 18, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28921418/coping-with-phantom-limb-pain
#2
Damien P Kuffler
Phantom limb pain is a chronic neuropathic pain that develops in 45-85% of patients who undergo major amputations of the upper and lower extremities and appears predominantly during two time frames following an amputation: the first month and later about 1 year. Although in most patients the frequency and intensity of pain diminish over time, severe pain persists in about 5-10%. It has been proposed that factors in both the peripheral and central nervous systems play major roles in triggering the development and maintenance of pain associated with extremity amputations...
September 18, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28886692/supernumerary-phantom-limb-in-a-patient-with-basal-ganglia-hemorrhage-a-case-report-and-review-of-the-literature
#3
Hang-Rai Kim, Jee-Young Han, Young Ho Park, Beom Joon Kim, Wookjin Yang, SangYun Kim
BACKGROUND: Supernumerary phantom limb (SPL) is a rare neurologic phenomenon, in which a patient misperceives an extra limb in addition to the original set of limbs. We report a case of SPL in a patient with a right basal ganglia hemorrhage and review the previous literature about this peculiar phenomenon. CASE PRESENTATION: Two days after the event of a right basal ganglia hemorrhage, a 78-year-old male reported a phantom arm protruding from his left shoulder. He could not see or touch the phantom arm but he felt the presence of an addition arm lateral to his paretic arm...
September 8, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28874923/noninvasive-brain-stimulation-maladaptive-plasticity-and-bayesian-analysis-in-phantom-limb-pain
#4
REVIEW
Leon Morales-Quezada
Introduction: Phantom limb pain (PLP) is a common and poorly understood pathology of difficult medical control that progressively takes place after amputation occurs. Objective: This article discusses the multifactorial bases of PLP. These bases involve local changes at the stump level, spinal modifications of excitability, deafferentation, and central sensitization, leading to the development of maladaptive plasticity, and consequentially, defective processing of sensory information by associative neural networks...
August 1, 2017: Medical Acupuncture
https://www.readbyqxmd.com/read/28860841/a-review-of-the-management-of-phantom-limb-pain-challenges-and-solutions
#5
REVIEW
Cliff Richardson, Jai Kulkarni
BACKGROUND: Phantom limb pain (PLP) occurs in 50% and 80% of amputees. Although it is often classified as a neuropathic pain, few of the large-scale trials of treatments for neuropathic pain included sufficient numbers of PLP sufferers to have confidence that they are effective in this condition. Many therapies have been administered to amputees with PLP over the years; however, as of yet, there appears to be no first-line treatment. OBJECTIVES: To comprehensively review the literature on treatment modalities for PLP and to identify the challenges currently faced by clinicians dealing with this pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28831329/targeted-muscle-reinnervation-to-improve-pain-prosthetic-tolerance-and-bioprosthetic-outcomes-in-the-amputee
#6
REVIEW
J Byers Bowen, Corinne E Wee, Jaclyn Kalik, Ian L Valerio
Scope and Significance: There are ∼185,000 amputations each year and nearly 2 million amputees currently living in the United States. Approximately 25% of these amputees will experience chronic pain issues secondary to localized neuroma pain and/or phantom limb pain. Problem: The significant discomfort caused by neuroma and phantom limb pain interferes with prosthesis wear, subjecting amputees to the additional physical and psychological morbidity associated with chronic immobility. Although numerous neuroma treatments are described, none of these methods are consistently effective in eliminating symptoms...
August 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28822914/motor-correlates-of-phantom-limb-pain
#7
Sanne Kikkert, Melvin Mezue, David Henderson Slater, Heidi Johansen-Berg, Irene Tracey, Tamar R Makin
Following amputation, individuals ubiquitously report experiencing lingering sensations of their missing limb. While phantom sensations can be innocuous, they are often manifested as painful. Phantom limb pain (PLP) is notorious for being difficult to monitor and treat. A major challenge in PLP management is the difficulty in assessing PLP symptoms, given the physical absence of the affected body part. Here, we offer a means of quantifying chronic PLP by harnessing the known ability of amputees to voluntarily move their phantom limbs...
July 25, 2017: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
https://www.readbyqxmd.com/read/28813955/robotic-therapy-for-phantom-limb-pain-in-upper-limb-amputees
#8
Peter W Snow, Imad Sedki, Marco Sinisi, Richard Comley, Rui C V Loureiro
The system described in this paper combines virtual reality with haptic feedback to increase the level of immersion and invoke the sense of agency in patients with phantom limb pain with the aim of reducing perceived pain. This paper presents three case studies of an on-going clinical study. The initial results suggest an increased sense of embodiment of the virtual limb promotes a decrease in perceived levels of pain. The results strengthen the view that the cortical map does not fully "disappear" yet lays dormant...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28802070/memantine-for-the-treatment-of-general-neuropathic-pain-a-narrative-review
#9
REVIEW
Gisèle Pickering, Véronique Morel
Neuropathic pain (NP) is difficult to treat and is associated with a decline in quality of life. NP aetiologies are numerous and a number of pathologies display neuropathic characteristics. Of the various N-Methyl-D-Aspartate antagonists that are alternatives to recommended in first-line NP treatment, memantine has the safest side-effect profile and has long been approved in Alzheimer's disease. The review covers memantine studies in post-herpetic neuralgia, diabetic pain, postoperative pain, complex regional pain syndrome, chronic phantom limb pain, opioid refractory pain, and fibromyalgia...
August 12, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28793825/controlling-acute-pain-to-improve-the-quality-of-postoperative-pain-management-an-update-from-the-european-society-of-regional-anesthesia-meeting-held-in-maastricht-september-2016
#10
Jose De Andrés, Esther Pogatzki-Zahn, Frank Huygen, Edmund Neugebauer, William Fawcett
Improvement in postoperative pain management remains a global concern with a significant unmet need for patients. This was the focus of a 'Change Pain' session at the 35th European Society of Regional Anesthesia meeting (Maastricht, September 2016). Awareness of the size and nature of the problem is important to improve postoperative pain management strategies. Optimal treatment of acute pain should aim to avoid long-term sequelae such as the development of chronic pain disorders (e.g., phantom limb pain)...
August 10, 2017: Pain Management
https://www.readbyqxmd.com/read/28776544/quantitative-evaluation-of-pain-with-pain-index-extracted-from-electroencephalogram
#11
Jian-Xiong An, Yong Wang, Doris K Cope, John P Williams
BACKGROUND: The current pain assessment methods are strongly subjective and easily affected by outside influences, and there is an urgent need to develop a reliable objective and quantitative pain-monitoring indicator. The aim of this study was to evaluate the feasibility of using Pain index (Pi) to assess pain symptoms in pain patients. METHODS: Subjects were enrolled from patients seeking treatment at Pain Medicine Center of China Medical University Aviation General Hospital from October 2015 to December 2016, such as postherpetic neuralgia, spinal cord injury, femoral head necrosis, lumbar disc herniation, trigeminal neuralgia, complex regional pain syndrome, perineal pain, phantom limb pain, etc...
August 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28761369/capsaicin-8-patch-treatment-for-amputation-stump-and-phantom-limb-pain-a-clinical-and-functional-mri-study
#12
Rosario Privitera, Rolfe Birch, Marco Sinisi, Iordan R Mihaylov, Robert Leech, Praveen Anand
PURPOSE: The aim of this study was to measure the efficacy of a single 60 min application of capsaicin 8% patch in reducing chronic amputation stump and phantom limb pain, associated hypersensitivity with quantitative sensory testing, and changes in brain cortical maps using functional MRI (fMRI) scans. METHODS: A capsaicin 8% patch (Qutenza) treatment study was conducted on 14 patients with single limb amputation, who reported pain intensity on the Numerical Pain Rating Scale ≥4/10 for chronic stump or phantom limb pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28736545/a-randomized-controlled-trial-of-mirror-therapy-for-upper-extremity-phantom-limb-pain-in-male-amputees
#13
Sacha B Finn, Briana N Perry, Jay E Clasing, Lisa S Walters, Sandra L Jarzombek, Sean Curran, Minoo Rouhanian, Mary S Keszler, Lindsay K Hussey-Andersen, Sharon R Weeks, Paul F Pasquina, Jack W Tsao
OBJECTIVE: Phantom limb pain (PLP) is prevalent in patients post-amputation and is difficult to treat. We assessed the efficacy of mirror therapy in relieving PLP in unilateral, upper extremity male amputees. METHODS: Fifteen participants from Walter Reed and Brooke Army Medical Centers were randomly assigned to one of two groups: mirror therapy (n = 9) or control (n = 6, covered mirror or mental visualization therapy). Participants were asked to perform 15 min of their assigned therapy daily for 5 days/week for 4 weeks...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28728802/-psychotherapies-for-the-treatment-of-phantom-limb-pain
#14
Katherine Cárdenas, Mariana Aranda
INTRODUCTION: The phantom limb pain has been described as a condition in which patients experience a feeling of itching, spasm or pain in a limb or body part that has been previously amputated. Such pain can be induced by a conflict between the representation of the visual and proprioceptive feedback of the previously healthy limb. The phantom limb pain occurs in at least 42 to 90% of amputees. Regular drug treatment of phantom limb pain is almost never effective. METHODS: A systematic review of the literature was conducted in Medline and Cochrane using the MESH terms "phantom limb pain" and "psychotherapy", published in the last 10 years, in English and Spanish, finding 49 items...
July 2017: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/28723767/return-of-the-cadaver-key-role-of-anatomic-dissection-for-plastic-surgery-resident-training
#15
Swenn Maxence Krähenbühl, Paul Čvančara, Thomas Stieglitz, Raphaël Bonvin, Murielle Michetti, Marjorie Flahaut, Sébastien Durand, Lina Deghayli, Lee Ann Applegate, Wassim Raffoul
Successful Plastic Surgery Residency training is subjected to evolving society pressure of lower hourly work weeks imposed by external committees, labor laws, and increased public awareness of patient care quality. Although innovative measures for simulation training of surgery are appearing, there is also the realization that basic anatomy training should be re-enforced and cadaver dissection is of utmost importance for surgical techniques.In the development of new technology for implantable neurostimulatory electrodes for the management of phantom limb pain in amputee patients, a design of a cadaveric model has been developed with detailed steps for innovative transfascicular insertion of electrodes...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28691602/somatosensory-feedback-to-the-cheek-during-virtual-visual-feedback-therapy-enhances-pain-alleviation-for-phantom-arms
#16
Akimichi Ichinose, Yuko Sano, Michihiro Osumi, Masahiko Sumitani, Shin-Ichiro Kumagaya, Yasuo Kuniyoshi
BACKGROUND: Patients who suffer from phantom limb pain can perceive tactile stimuli applied to the cheek on their affected side as if it were coming from their phantom limb, a phenomenon called "referred sensation." OBJECTIVES: To investigate the analgesic effect produced by tactile feedback provided to the cheek during neurorehabilitation using visual feedback. METHODS: Nine participants with phantom upper limb pain performed virtual reality neurorehabilitation exercises in which they repeatedly touched a target object with a virtual representation of their affected limb...
August 2017: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/28681962/systematic-review-of-management-of-chronic-pain-after-surgery
#17
REVIEW
V Wylde, J Dennis, A D Beswick, J Bruce, C Eccleston, N Howells, T J Peters, R Gooberman-Hill
BACKGROUND: Pain present for at least 3 months after a surgical procedure is considered chronic postsurgical pain (CPSP) and affects 10-50 per cent of patients. Interventions for CPSP may focus on the underlying condition that indicated surgery, the aetiology of new-onset pain or be multifactorial in recognition of the diverse causes of this pain. The aim of this systematic review was to identify RCTs of interventions for the management of CPSP, and synthesize data across treatment type to estimate their effectiveness and safety...
September 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28676749/preliminary-evidence-for-training-induced-changes-of-morphology-and-phantom-limb-pain
#18
Sandra Preißler, Désirée Thielemann, Caroline Dietrich, Gunther O Hofmann, Wolfgang H R Miltner, Thomas Weiss
The aim of this study was to investigate whether a special prosthetic training in phantom limb pain patients aimed at increasing the functional use of the prosthesis leads to neural morphological plasticity of brain structures and a reduction in phantom limb pain. For chronic pain disorders, it was shown that morphological alterations due to pain might become at least partially reversed by pain therapies. Phantom limb pain is a chronic pain disorder that is frequently followed by neural plasticity of anatomical brain structures...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28631870/thalamic-deep-brain-stimulation-for-neuropathic-pain-efficacy-at-three-years-follow-up
#19
Vasco Abreu, Rui Vaz, Virgínia Rebelo, Maria José Rosas, Clara Chamadoira, Martin J Gillies, Tipu Z Aziz, Erlick A C Pereira
OBJECT: Chronic neuropathic pain is estimated to affect 3-4.5% of the worldwide population, posing a serious burden to society. Deep Brain Stimulation (DBS) is already established for movement disorders and also used to treat some "off-label" conditions. However, DBS for the treatment of chronic, drug refractory, neuropathic pain, has shown variable outcomes with few studies performed in the last decade. Thus, this procedure has consensus approval in parts of Europe but not the USA. This study prospectively evaluated the efficacy at three years of DBS for neuropathic pain...
June 20, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28616655/-cognitive-perceptive-approaches-in-the-treatment-of-chronic-pain
#20
REVIEW
C Storz, H Schulte-Göcking, M Azqueta, C Wania, M Neugebauer, A Reiners, S Azad, E Kraft
In the treatment of difficult chronic pain conditions, cognitive-perceptive approaches offer an alternative to conventional therapies. Especially phantom limb pain and complex regional pain syndrome (CRPS) are frequently treated with these promising modalities. This article provides an overview of the most important cognitive-perceptive therapies and the research results concerning their clinical efficacy. In addition, we discuss their neurobiological foundation and clinical perspectives.
June 14, 2017: Der Schmerz
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