Article

The formation, prevalence, intensity, course, and predisposing
factors of phantom limb pain were investigated to determine possible mechanisms
of the origin of phantom limb pain in traumatic upper limb amputees. METHODS:
Ninety-six upper limb amputees participated in the study. A questionnaire
assessed the following question: side, date, extension, and cause of amputation;
preamputation pain; and presence or absence of phantom pain, phantom and stump
sensations or stump pain or both. RESULTS: The response rate was 84%. Sixty-five
(81%) participants returned the questionnaire. In 64 (98.5%) participants a
traumatic injury led to amputation; the amputation was necessary because of
infection in one patient (1.5%). The median follow-up time (from amputation to
evaluation) was 3.2 years (range, 0.9-3.8 years) The prevalence of phantom pain
was 44.6%, phantom sensation 53.8%, stump pain 61.5%, and stump sensation 78.5%.
After its first appearance, phantom pain had a decreasing course in 14 (48.2%) of
29 amputees, was stable in 11 (37.9%) amputees, and worsened in 2 (6.9%) of 29
amputees. Stump pain had a decreasing course in 19 (47.5%) of 40 amputees but was
stable in 12 (30%) amputees. Phantom pain occurred immediately after amputation
in 8 (28%) of 29 amputees between 1 month and 12 months in 3 (10%) amputees and
after 12 or more months in 12 (41%) amputees. CONCLUSION: Stump pain and stump
sensation predominate traumatic amputees' somatosensory experience immediately
after amputation; phantom pain and phantom sensations are often long-term
consequences of amputation. Amputees experience phantom sensations and phantom
pain within 1 month after amputation, a second peak occurs 12 months after
amputation. Revised diagnostic criteria for phantom pain are proposed on the
basis of these data.

Langue : ANGLAIS

Tiré à part : OUI