Clinical presentation and management of phantom pain


Authors: J. Lejčko
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny, Centrum léčby bolesti, Fakultní nemocnice Plzeň ;  Lékařská fakulta v Plzni, Univerzita Karlova
Published in: Anest. intenziv. Med., 30, 2019, č. 1, s. 27-32
Category:

Overview

Phantom limb pain is a relatively common and disabling condition with a negative impact on the quality of life. Simultaneously with this exceptional type of pain, stump pain frequently occurs. Phantom pain is considered neuropathic pain. Clinical picture of phantom limb pain is influenced by a number of factors - pre-amputation pain, site of amputation, gender, etc. The exact pathophysiological mechanisms of phantom pain have not yet been defined. Presumably, peripheral and central neuroplastic changes involving cortical reorganization are key factor in the genesis of phantom pain. The role of ‘mirror’ neurons in the prefrontal cortex has been proposed. Many treatments have been tested but none of them are specific for phantom pain. The relevance of pre-emptive analgesia in the prevention of phantom limb pain is the subject of clinical research. The best treatment results have been achieved by a multimodal approach.

Keywords:

phantom pain – stump pain – neuroplasticity – multimodal therapy


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Anaesthesiology, Resuscitation and Inten Intensive Care Medicine
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