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Phantom limb pain

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https://www.readbyqxmd.com/read/29764303/relief-from-intractable-phantom-pain-by-combining-psilocybin-and-mirror-visual-feedback-mvf
#1
Vilayanur Ramachandran, Chaipat Chunharas, Zeve Marcus, Timothy Furnish, Albert Lin
AL's leg was amputated resulting in phantom-limb pain (PLP). (1) When a volunteer placed her foot on or near the phantom - touching it evoked organized sensations in corresponding locations on AL's phantom. (2) Mirror-visual-feedback (MVF) relieved PLP, as did, "phantom massage". (3) Psilocybin-MVF pairing produced synergistic effects, complete elimination of PLP, and reduction in paroxysmal episodes. (4) Touching the volunteer's leg where AL previously had external fixators, evoked sensation of nails boring through the leg...
May 15, 2018: Neurocase
https://www.readbyqxmd.com/read/29755399/leg-prosthesis-with-somatosensory-feedback-reduces-phantom-limb-pain-and-increases-functionality
#2
Caroline Dietrich, Sandra Nehrdich, Sandra Seifert, Kathrin R Blume, Wolfgang H R Miltner, Gunther O Hofmann, Thomas Weiss
Phantom limb pain (PLP) develops in most patients with lower limb amputation. Changes in the peripheral and central nervous system (CNS) are hypothesized to contribute to PLP. Based on ideas to modify neural reorganization within the CNS, the aim of the study was to test, whether prostheses with somatosensory feedback might help to reduce PLP, and increase the functionality of movement with a prosthesis. We therefore equipped the prostheses of 14 lower leg amputees with a simple to use feedback system that provides electrocutaneous feedback to patients' thigh whenever the foot and toes of the prosthesis touch the ground...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29686645/phantom-limb-pain-in-pediatric-oncology
#3
REVIEW
Patrick DeMoss, Logan H Ramsey, Cynthia Windham Karlson
Phantom limb pain (PLP) is a prevalent problem for children and adolescents undergoing amputation due to cancer treatment. The symptoms are wide ranging from sharp to tingling. PLP in children typically lasts for a few minutes but can be almost constant and can be highly distressing. This focused review describes the characteristics, epidemiology, mechanisms, and evidence-based treatment of PLP in pediatric populations, focusing on pediatric cancer. In pediatric oncology, the administration of chemotherapy is a risk factor that potentially sensitizes the nervous system and predisposes pediatric cancer patients to develop PLP after amputation...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29666885/referred-cramping-phantom-hand-pain-elicited-in-the-face-and-eliminated-by-peripheral-nerve-block
#4
Caroline Dietrich, Sandra Nehrdich, Annette Zimmer, Alexander Ritter, Gunther O Hofmann, Wolfgang H R Miltner, Thomas Weiss
Phantom limb pain is a restricting condition for a substantial number of amputees with quite different characteristics of pain. Here, we report on a forearm amputee with constant phantom pain in the hand, in whom we could regularly elicit the rare phenomenon of referred cramping phantom pain by touching the face. To clarify the underlying mechanisms, we followed the cramp during the course of an axillary blockade of the brachial plexus. During the blockade, both phantom pain and the referred cramp were abolished, while a referred sensation of "being touched at the phantom" persisted...
April 17, 2018: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/29620980/management-of-lower-limb-amputations
#5
Alifa Isaacs-Itua, Imad Sedki
The most common reason for lower limb amputations in the UK is peripheral arterial disease. A thoughtful approach to surgery, with consideration of optimal amputation level and residual limb shape, can improve prosthetic use and functional outcomes. Prosthesis socket design and fit, as well as use of appropriate components, must be considered in accordance with the patient's activity level and potential. Major developments in prosthetics over the past 20 years, particularly in the area of joint design, including microprocessor knees, have increased options to improve ambulation...
April 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29616149/immersive-virtual-reality-therapy-with-myoelectric-control-for-treatment-resistant-phantom-limb-pain-case-report
#6
Brian Chau, Ivan Phelan, Phillip Ta, Sarah Humbert, Justin Hata, Duc Tran
Objective: Phantom limb pain is a condition frequently experienced after amputation. One treatment for phantom limb pain is traditional mirror therapy, yet some patients do not respond to this intervention, and immersive virtual reality mirror therapy offers some potential advantages. We report the case of a patient with severe phantom limb pain following an upper limb amputation and successful treatment with therapy in a custom virtual reality environment. Methods: An interactive 3-D kitchen environment was developed based on the principles of mirror therapy to allow for control of virtual hands while wearing a motion-tracked, head-mounted virtual reality display...
July 2017: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/29551734/removing-own-limb-visual-input-using-mixed-reality-mr-produces-a-telescoping-illusion-in-healthy-individuals
#7
Mikkel Thøgersen, John Hansen, Lars Arendt-Nielsen, Herta Flor, Laura Petrini
The purpose of the present study was to assess changes in body perception when visual feedback was removed from the hand and arm with the purpose of resembling the visual deprivation arising from amputation. The illusion was created by removing the visual feedback from the participants' own left forearm using a mixed reality (MR) and green screen environment. Thirty healthy persons (15 female) participated in the study. Each subject experienced two MR conditions, one with and one without visual feedback from the left hand, and a baseline condition with normal vision of the limb (no MR)...
March 15, 2018: Behavioural Brain Research
https://www.readbyqxmd.com/read/29533387/dilute-lidocaine-suppresses-ectopic-neuropathic-discharge-in-drgs-without-blocking-axonal-propagation-a-new-approach-to-selective-pain-control
#8
Pini Koplovitch, Marshall Devor
Ectopic impulse discharge (ectopia) generated in the soma of afferent neurons in dorsal root ganglia (DRGs) following nerve injury is thought to be a major contributor to neuropathic pain. The DRG is thus a prime interventional target. The process of electrogenesis (impulse generation) in the DRG is far more sensitive to systemically administered Na channel blockers than the process of impulse propagation along sensory axons. It should therefore be possible to selectively suppress DRG ectopia with local application of membrane stabilizing agents without blocking normal impulse traffic...
March 12, 2018: Pain
https://www.readbyqxmd.com/read/29528455/lumbar-sympathetic-plexus-block-as-a-treatment-for-postamputation-pain-methodology-for-a-randomized-controlled-trial
#9
Zachary L McCormick, Andrew Hendrix, David Dayanim, Bryan Clay, Amy Kirsling, Norman Harden
Objective: We present a technical protocol for rigorous assessment of patient-reported outcomes and psychophysical testing relevant to lumbar sympathetic blocks for the treatment of postamputation pain (PAP). This description is intended to inform future prospective investigation. Design: Series of four participants from a blinded randomized sham-controlled trial. Setting: Tertiary, urban, academic pain medicine center. Subjects: Four participants with a single lower limb amputation and associated chronic PAP...
March 8, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29515513/immersive-low-cost-virtual-reality-treatment-for-phantom-limb-pain-evidence-from-two-cases
#10
Elisabetta Ambron, Alexander Miller, Katherine J Kuchenbecker, Laurel J Buxbaum, H Branch Coslett
Up to 90% of amputees experience sensations in their phantom limb, often including strong, persistent phantom limb pain (PLP). Standard treatments do not provide relief for the majority of people who experience PLP, but virtual reality (VR) has shown promise. This study provides additional evidence that game-like training with low-cost immersive VR activities can reduce PLP in lower-limb amputees. The user of our system views a real-time rendering of two intact legs in a head-mounted display while playing a set of custom games...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29502531/assistive-technologies-for-pain-management-in-people-with-amputation-a-literature-review
#11
REVIEW
Kamiar Ghoseiri, Mostafa Allami, Mohammad Reza Soroush, Mohammad Yusuf Rastkhadiv
The prevalence of limb amputation is increasing globally as a devastating experience that can physically and psychologically affect the lifestyle of a person. The residual limb pain and phantom limb pain are common disabling sequelae after amputation surgery. Assistive devices/technologies can be used to relieve pain in people with amputation. The existing assistive devices/technologies for pain management in people with amputation include electrical nerve block devices/technologies, TENS units, elastomeric pumps and catheters, residual limb covers, laser systems, myoelectric prostheses and virtual reality systems, etc...
January 23, 2018: Military Medical Research
https://www.readbyqxmd.com/read/29497188/intervention-for-phantom-limb-pain-a-randomized-single-crossover-study-of-mirror-therapy
#12
Shashikumar Ramadugu, Satish C Nagabushnam, Nagendra Katuwal, Kaushik Chatterjee
Introduction: Mirror therapy suggested to help relieve phantom limb pain (PLP) by resolving the visual- proprioceptive dissociation in the brain, but studies so far either had shorter follow-up or smaller sample size. Materials and Methods: In this randomized single crossover trial, 64 amputees with PLP in the age group of 15-75 years of age were distributed into test and control groups by simple randomization method. Of these 28 in control and 32 in test groups, respectively, completed the 4 weeks of mirror therapy and 12 weeks of follow-up assessments...
October 2017: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/29451665/mirror-therapy-a-potential-intervention-for-pain-management
#13
REVIEW
Priscilla G Wittkopf, Mark I Johnson
The consequences of chronic pain and associated disabilities to the patient and to the health care system are well known. Medication is often the first treatment of choice for chronic pain, although side effects and high costs restrict long-term use. Inexpensive, safe and easy to self-administer non-pharmacological therapies, such as mirror therapy, are recommended as adjuncts to pain treatment. The purpose of this review is to describe the principles of use of mirror therapy so it can be incorporated into a health care delivery...
November 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29388508/retrieving-autobiographical-experience-of-painful-events-in-a-phantom-limb-brain-concomitants-in-a-case-report
#14
Céline Borg, Isabelle Faillenot, Roland Peyron, Bernard Laurent
We report the case of a patient who had an important experience with painful events, allowing the investigation of brain concomitants to painful (P) memories in fMRI. The patient had to recall P events that were contrasted with non-painful (NP) memories. Painful memories of the right lower limb activated the left paracentral lobule,fronto-insular operculum and superior parietal cortex. Additionally, whilst the recall of non-painful events activated the hippocampus, the recall of painful events did not enhance the hippocampal signal to significant levels...
February 2018: Neurocase
https://www.readbyqxmd.com/read/29380683/resting-state-fmr-evidence-of-network-reorganization-induced-by-navigated-transcranial-magnetic-repetitive-stimulation-in-phantom-limb-pain
#15
Antonino Scibilia, Alfredo Conti, Giovanni Raffa, Francesca Granata, Rosaria Viola Abbritti, Stefano Maria Priola, Carmela Sindorio, Salvatore Cardali, Antonino Germanò
Objectives Repetitive transcranial magnetic stimulation (rTMS) is a promising tool for treatment of chronic pain. We describe the use of navigated rTMS to treat a patient affected by phantom limb pain (PLP) and to modulate brain functional connectivity. We reviewed the literature on the use of rTMS as a tool for relieving central pain by promoting brain plasticity. Methods A 69-year-old patient came to our observation blaming severe pain (Visual Analog scale, VAS, score 9) to a phantom right lower limb. We mapped left primary motor area (PMA) by navigated TMS and assessed connectivity with resting-state functional MR (rsfMR)...
April 2018: Neurological Research
https://www.readbyqxmd.com/read/29377758/levorphanol-for-treatment-of-intractable-neuropathic-pain-in-cancer-patients
#16
Akhila Reddy, Amy Ng, Tarun Mallipeddi, Eduardo Bruera
Neuropathic pain in cancer patients is often difficult to treat, requiring a combination of several different pharmacological therapies. We describe two patients with complex neuropathic pain syndromes in the form of phantom limb pain and Brown-Sequard syndrome who did not respond to conventional treatments but responded dramatically to the addition of levorphanol. Levorphanol is a synthetic strong opioid that is a potent N-methyl-d-aspartate receptor antagonist, mu, kappa, and delta opioid receptor agonist, and reuptake inhibitor of serotonin and norepinephrine...
March 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29343050/phantom-limb-pain-successfully-treated-with-scrambler-therapy
#17
Laura Fabbri, Sara P Pirotti, Marta Rosati, Nicola Ruffilli, Marco Maltoni, Marianna Ricci
No abstract text is available yet for this article.
January 17, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29331287/characterizing-the-effects-of-deep-brain-stimulation-with-magnetoencephalography-a-review
#18
REVIEW
Irene E Harmsen, Nathan C Rowland, Richard A Wennberg, Andres M Lozano
BACKGROUND: Deep brain stimulation (DBS) is an important form of neuromodulation that is being applied to patients with motor, mood, or cognitive circuit disorders. Despite the efficacy and widespread use of DBS, the precise mechanisms by which it works remain unknown. Over the last decade, magnetoencephalography (MEG) has become an important functional neuroimaging technique used to study DBS. OBJECTIVE: This review summarizes the literature related to the use of MEG to characterize the effects of DBS...
January 4, 2018: Brain Stimulation
https://www.readbyqxmd.com/read/29284534/perineural-local-anaesthetic-catheter-after-major-lower-limb-amputation-trial-placement-study-protocol-for-a-randomised-controlled-pilot-study
#19
David C Bosanquet, Graeme K Ambler, Cherry-Ann Waldron, Emma Thomas-Jones, Lucy Brookes-Howell, Mark Kelson, Tim Pickles, Debbie Harris, Deborah Fitzsimmons, Neeraj Saxena, Christopher P Twine
BACKGROUND: Pain after major lower limb amputation for peripheral arterial disease (PAD) is a significant problem. A perineural catheter (PNC) can be placed adjacent to the major nerve at the time of amputation with a continuous local anaesthetic infusion given postoperatively to try and reduce pain. Although low-quality observational data suggest that PNC usage reduces postoperative opioid requirements, there are limited data regarding its effect on pain. The aim of PLACEMENT is to explore the feasibility of running an effectiveness trial to assess the impact of a PNC with continuous local anaesthetic infusion, inserted at the time of amputation, on short and medium-term postoperative outcomes...
December 28, 2017: Trials
https://www.readbyqxmd.com/read/29221844/gabapentin-as-an-adjuvant-therapy-for-prevention-of-acute-phantom-limb-pain-in-pediatric-patients-undergoing-amputation-for-malignant-bone-tumors-a-prospective-double-blind-randomized-controlled-trial
#20
Xiandi Wang, Ying Yi, Dingbo Tang, Yi Chen, Yanhua Jiang, Jun Peng, Jiwei Xiao
CONTEXT: Gabapentin is reported to have an analgesic effect of reducing phantom-limb pain (PLP) in adult patients. There is no study on preoperative use of gabapentin in pediatric population in terms of PLP prevention. OBJECTIVE: To determine whether gabapentin could be used as an adjuvant agent of opioid-based pain control to lower the rate of PLP in pediatric patients undergoing amputation for malignant bone tumors in observation period of 60 days postoperatively...
March 2018: Journal of Pain and Symptom Management
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