Phantom and stump pain : [material ... presented at the 5th annual meeting of the German skeaking chapter of the International Association for the Study of Pain, Gesellschaft zum Studium des Schmerzes für Deutschland, Österreich und die Schweiz, held in

The phenomenon of phantom limb was described in medical literature at least as early as 1545 by Ambroise Pare, according to the notes in the translation of Lemos' dissertation, "On the Continuing Pain of an Amputated Limb", by Price and Twombly [9]. This strange experience was brought to public attention by a popular essay anonymously published 1866 by Mitchell concerning the story of George Dedlow, a quadriamputee who described his invisible limbs [7]. In 1871 Mitchell wrote under his own name, and was the. first to use the term "phantom limb" [8]. In this work, he also corrected some erroneous beliefs that had arisen from his 1866 essay [13]. Most amputees report feeling a phantom limb almost immediately after amputation of an arm or a leg [11]. It is a positive sensation, usually described as tingling or numbness, which is not painful. The most distal parts of the limb, particulary the digits, thumb, and index, are the strongest and most persisting phantom sites, and may be the only parts to appear even after removal of a whole limb. The elbow or knee is sometimes involved, the forearm or lower leg rarely, and the upper arm and thigh almost never [5]. The phantom thus appears to consist predominantly of those parts which have the most extensive representa­ tion in the thalamus and in the cerebral cortex. Front Matter....Pages I-X Front Matter....Pages 1-1 On the Origin of Pain Associated with Amputation....Pages 2-14 Neurophysiological Analysis of Efferent Sympathetic and Afferent Fibers in Skin Nerves with Experimentally Produced Neuromata....Pages 15-31 Somatosensory Evoked Potentials in Above-Knee Amputees with Phantom and Stump Pain....Pages 32-41 Front Matter....Pages 43-43 Clinical and Neurophysiological Findings in Above-Knee Amputees: A Synopsis....Pages 44-50 The Phenomenology of Postamputation Pain....Pages 51-55 Phantom Sensations After Amputation: The Importance of Localization and Prognosis....Pages 56-61 Phantom Sensations (Phantom Arm) in Plexus Paralysis....Pages 62-65 Phantom Illusions in Spinal Cord Lesions....Pages 66-73 Phantom Limb Pain in Arterial Occlusive Disease....Pages 74-76 Phantom Tooth Phenomenon: Painless and Painful Sensations....Pages 77-80 Phantom Tooth....Pages 81-83 The Analysis of Personality Factors in the Prediction of Phantom Limb Pain....Pages 84-88 Front Matter....Pages 89-89 Drug Treatment of Phantom and Stump Pain....Pages 90-92 Treatment of Phantom Pain by Transcutaneous Stimulation (TNS) of the Stump, the Limb Contralateral to the Stump, and the Other Extremities....Pages 93-98 Transcutaneous Electrical Nerve Stimulation in Postamputation Pain....Pages 99-102 Transcutaneous Electrical Nerve Stimulation (TNS) in the Treatment of Chronic Pain After Peripheral Nerve Lesions....Pages 103-106 Contralateral Local Anesthesia for the Treatment of Postamputation Pain....Pages 107-109 Rehabilitation of Elderly Amputees: Stump and Phantom Pain....Pages 110-116 Front Matter....Pages 117-117 Surgical Stump Revision as a Treatment of Stump and Phantom Pains: Results of 100 Cases....Pages 118-122 Centrocentral Anastomosis of Peripheral Nerves: A Neurosurgical Treatment of Amputation Neuromas....Pages 123-125 Front Matter....Pages 117-117 The Effects on Pain of Reconstructive Neurosurgery in 160 Patients with Traction and/or Crush Injury to the Brachial Plexus....Pages 126-147 Neurosurgical Treatment of Phantom Limb Pain: A Survey of Methods....Pages 148-155 Thermocoagulation of the Substantia Gelatinosa for Pain Relief — (Preliminary Report)....Pages 156-159 Treatment of Phantom and Stump Pain with Controlled Thermocoagulation of Amputation Neuroma....Pages 160-162 Spinal Cord Stimulation in Postamputation Pain....Pages 163-166 Programmed Transcutaneous (TNS) and Central (DBS) Stimulation for Control of Phantom Limb Pain and Causalgia: A New Method for Treatment....Pages 167-178 Back Matter....Pages 179-185