phantom limb syndrome
The most commonly used term for chronic intense pain localised to the site of an amputated or denervated limb; 60-70% of amputees have a phantom limb sensation; 10-15% have phantom limb syndrome. The pain often reflects the amount of pre-amputation pain, and is often refractory to excision of amputation neuroma, rubbing, electrical stimulation, peripheral nerve or spinal blocks, narcotics, sympathectomy or any other therapy.
Management Use of a mirror in a box that places the intact limb visually in the same site as the missing extremity; with the use of symmetrical movements, the patient “unlearns” activities that were formerly carried out by the missing limb.
In a study of 75 paediatric amputees, phantom limb pain occurred in half of cancer-related amputations, and 12% of trauma-related amputations Note: Lord Horatio Nelson–1758-1805 lost his lower right arm when his fleet attacked the post of Santa Cruz in Tenerife–Canary Islands and suffered from phantom limb syndrome until his death
Synonym Phantom limb pain
References NY Times 28/3/95, C3
MCP 1995; 70:357oa
Proc Roy Soc Med 1970; 63:299