Disappearance of phantom limb pain during cauda equina compression by spinal meningioma and gradual reactivation after decompression.
ABSTRACT We describe a 65-yr-old woman, whose right lower limb had been amputated at the mid-femoral level because of complicated femur fracture sustained at the age of 5 yr. After amputation, she experienced phantom limb pain (PLP), which gradually decreased in intensity but persisted for 60 yr. At this point the pain diminished progressively, in parallel with the evolution of cauda equina compression caused by an intraspinal tumor. The PLP gradually reappeared over 3 mo after surgical removal of the tumor. IMPLICATIONS: We present a case in which phantom limb pain (PLP) in an amputated leg disappeared during cauda equina compression by meningioma and reactivated after surgical decompression. This case suggests that complete compression or blockade of nerves, a nerve plexus, the cauda equina, or the medullary cord may result in suppression of PLP, and decompression of or recovery from the block may cause reactivation.
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ABSTRACT: The sensations associated at times with neural lesions in the spinal canal may have the following features and phases: 1) early anosognosia, i.e. lack of awareness of disability; 2) initial stimulation; 3) illusion of amputation; 4) disappearance of that illusion and 5) grotesque sensations. Detailed features of the phantoms such as changes in their size, position, and vividness as well as tactics evoking changes in the sensations are recorded. The special situations are described in which paraplegia is accompanied by actual amputation, or there is a phantom of an upper limb after avulsion of the brachial plexus or after extensive posterior rhizotomy. Finally phantoms associated with incomplete lesions of the cord are analyzed and the basis presented for concluding that a lesion of an ipsilateral posterior column is responsible for the phantom experience in cord lesion.Neurochirurgia 10/1975; 18(5):139-54.
- Anesthesiology 09/1986; 65(2):220-1. · 5.16 Impact Factor
Article: Phantom limb pain.BJA British Journal of Anaesthesia 08/2001; 87(1):107-16. · 4.24 Impact Factor