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Main causes of phantom limb pain after amputation: an integrative review


Journal of Neurology & Stroke
Livia Barroca Vieira, Julia Vitali Gomes, Lorenza Passamani Loss Favarato, Victor Barbieri Cordeiro, Raphael Carlos Pinto Ferreira, Rodrigo Goltara Suaid, Marcela Souza Lima Paulo, Louise Cristina Passos Drumond, Juliana Cardoso de Souza Custodio

Abstract

Introduction: Phantom Limb Pain (PLP) is characterized in most cases of amputation, causing pain and emotional discomfort to the patient, which compromises quality of life. Objective: identify the main factors related to the cause of phantom limb pain. Methodology: This is an integrative review carried out between September and Octo-ber 2022, on the Pubmed and Virtual Health Library (VHL) platforms. The following search strategy was applied: (“Phantom Limb” OR pseudomelia) AND pain AND amputation AND (causality OR factors), according to the Health Sciences Descriptors system and articulated by Boolean operators. Results: The present study found 12 articles, it was observed that the majority of FMD cases occur due to amputations due to cancer and that, among its possible contributing factors, amputations of limbs at a level more proximal to the axial skeleton stand out, especially in losses above the level of the knee and above the level of the wrist, preoperative pain, with a tendency to generate a somatosensory memory and promote pain in the same location with similar intensity after amputation, applied anesthesia, simultaneous treatments of adverse diseases, psychological problems, such as depression and anxiety, and brain maladaptations associated with the peripheral nervous system and body representation, the latter in a way that favors changes that allow pain circuits to be functionally more active. The groups most likely to acquire PLP are women and individuals with less education. Patients mainly reported electrical sensations, itching, and a sensation of movement as manifestations of PLP. Despite the findings, there are certain contradictions between different studies available. Conclusion: The main causes of phantom limb pain are preoperative pain, psychological factors, the level of amputation and neurophysiological reorganization, and it is necessary to understand these causes with a view to the well-being and comfort of patients

Keywords

main factors, amputation, pain, phantom limb

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