The Phantom Limb

Phantom Limb syndrome was first acknowledged in 1552 by a French surgeon by the name of Ambroise Pare. Ambroise noticed these phenomenons with soldiers who have felt pain in their amputated limbs. Later in 1871 this disorder “Phantom Limb” was given its name by Mitchell, S. W.

The Phantom Limb syndrome is neurological disorder experienced by 50 to 80% of individuals who has previously undergone an amputated limb. This abnormal sensation can either be painful or non-painful, but the majority of the sensations experienced by individuals have been reported to be painful. Phantom sensations my also occur in other parts of the body other then the limb, such as an extraction of a tooth or a removal of an eye. The majority of people with Phantom Limb experience pain ranging from burning and shooting pain that feels like tingling of pins and needles. The remaining patients will sometimes experience the act of gesturing, itching sensations, twitches, and even try to pick up objects. In Studies by Ramachandran and Blakeslee, they describe that some patients descriptions of their limbs do not match what they’re actual limbs should be, in example, some patients would report their phantom limbs being too short. In another experiment conducted by Ramachandran and Blakeslee, a patient was ordered to grab a cup of coffee with his phantom limb, as the patient confirmed that he was reaching out, the cup was pulled away. The response received from the patient was pain even though his fingers were illusionary.

The dominant theory behind the reasoning for Phantom Limb was believed that it was associated with severed nerve endings called “neuromas”. Due to the severed nerve ending, the nerves would become inflamed, and was thought to send anomalous signals to the brain, causing abnormal interpretations by the brain as pain. Later this theory was proved as a failure as surgeons performed surgery to the amputees, hoping that shorting the stump would prevent the inflamed nerve endings, but instead the sensations heightened.

During the 1990s Tim Pons, at the National Institutes of Health, presented that the human brain can reorganize itself if sensory input were to come to a halt. With these new results, Vilayanur S. Ramachandran discovered the neuroplasticity maybe the explanation to the Phantom Limb Syndrome. Ramachandran believed that the specific explanation for this disorder was caused by map expansion neuroplasticity. Expansion neuroplasticity is the function of the brain where the local brain regions that are responsible for performing one type of function and reflected in the cerebral cortex as “maps”, can attain unused phantom maps. To further carry out his experiment, Ramachandran performed a test on an amputee by touching the side of the patients face with a cotton swab; it resulted in the patient also feeling the same sensation felt by his face was also felt by the patient’s phantom limb. Also a brain scan to the amputee using a magnetoencephalography (MEG) showed that the brain map for the patients face had taken over the adjacent area of the arm and hand brain map. With the data Ramachandran concluded that the amputated arm and hand’s brain map was starved for input therefore sending out growth-stimulating proteins that created neuronal sprouting from the face map which was stored in the adjacent are of the brain.

In some cases the symptoms of phantom limb syndrome undertakes on its own with some patients, others still experience severe symptoms, sometimes pain that cause debilitation. In this type of cases the symptoms can be suppressed through medication, hypnosis, shock therapy and acupuncture. Another alternative treatment is a novel therapy created by Ramachandran called the “Mirror Box”. It has been used by a small amount of patients, where the box mirrors the remaining limb of the patient to the missing phantom limb creating an illusion as if the missing limb is still intact. Although the success of this method is not completely understood, reports have shown that several patients have sustained long term relief.