Phantom Limb

[Wise Young]

Excellent article on phantom limb with detailed review of the literature.

http://www.snl.salk.edu/~ccarello/phantom

Wise.

[David Berg]

For a *completely* different take on phantom limbs Wise, have you ever seen Dr. S Weir Mitchell's fictional short story based on this?
http://www.painonline.org/Dedlow.htm

[Wise Young]

For a *completely* different take on phantom limbs Wise, have you ever seen Dr. S Weir Mitchell's fictional short story based on this?
http://www.painonline.org/Dedlow.htm

David, it is a wonderful article. It was also a remarkable description of the feelings that he had after the amputation.

It has often occurred to me that one of the treatments for neuropathic pain can and should be hypnosis. What the mind does, the mind should be able to undo.

Wise.

[alan]

I've tried hypnosis from three different hypnotists. I guess I couldn't relax enough to get ito a trance or something.

[dejerine]

This is a very tough field. Using EEG, it is probably established that in phantom pain there is medial displacement along S1 of the cortical representation of the receptive field.

However, PET scans have a much harder time showing predictable results, and the changes tend more to S2. The ratio of blood flow seems to favor the side of injury in area of the thalamus, but this was not always true. It may be that central pain is very much like phantom pain, but more dramatic and therefore more painful. I was taught, true or not, that amputation under local yields phantom pain half the time, while it is much decreased in general anesthesia.

I have thought long and hard about this, but it seems to suggest cortical reorganization is initiated rather early in the process and general anesthesia dminishes it. My own central pain occurred during an injury inflicted during anesthesia. I cannot imagine it could be any worse if I had been under local or even wide awake.

Maybe the ischemia occurred when I WAS awake, in the hours of the recovery room. As for Ramachandran's theory of the tip of the iceberg being cut off, I think it may be a model, but what it is based on, I have not been able to learn.

I assume CP occurs because the brain gets cut off from the environment, doesnt' like it, and recruits anything that still works. Pain being the most durable of sensations, it gets brought in. as the old reliable---why couldn't it have been pleasure of some kind. Could those of you who still experience pleasure remind me what it feels like? For those who don't, how do you fill your hours? Lying there in agony is just not doing it for me.

David recommended Canavero's new book on 'Central Pain to me. Worth having.