Plp Case Studies

Over the years scientists have noted many complaints of a strange form of pain called phantom limb pain. This pain is strange because it is located in an appendage that no longer exists. By many of the amputees the pain is described as totally unbearable. Phantom limb pain has even driven some victims crazy. For the amputee population this is a very real problem that definitely needs to be solved.

Both the A-delta fibers and C fibers are responsible for causing the woman phantom limb pain. She has suffered a severe mechanical deformation of amputation below the knee and the C fiber transmission of the dull, aching sensation to her amputated stump. For some patients, phantom limb pain gets better as time goes by. However, some patient may require treatments to manage the pain (McCance & Huether,

Also, many drugs have been used post surgery in treating PLP with success, particularly oral morphine. An inexpensive and easy drug-free therapy to follow, which its’ success in reducing PLP has been replicated in many studies, is mirror therapy. Mirror therapy also has the added benefit of being able to be done at home by the patient at his or her own pace. Finally, there are many novel therapies that have been very promising in treating PLP including cryoablation therapy of the affected nerve and/or neuroma, and EMDR therapy, which can simultaneously treat PTSD and similar

CRPS is uncommon, amongst all individuals, however, can easily affect a person after a traumatic injury to a limb. CRPS symptoms differ in severity and duration and the outcome for each individual is different, for example, children and teenager have a higher prospect of recovering, whereas others are left with irreversible variations regardless of treatment (National Institute of Neurological

The clinical presentation of DPN vary markedly from one patient to another depending on the type of sensory fibers involved. About 50% of patients is symptomatic, commonly present with a burning

Phantom Limb Pain (PLP) is a serious condition that occurs when a person who has lost a part of their body though amputation, trauma (brachial plexus), or loss of nervous connections in an appendage, perceives that the limb is still there and experiences sensations coming from this area. It was first described in 1866 by S. Weir Mitchell, an American neurologist, through a short story published in Atlantic Monthly. While Mitchell may then have wondered if this was specific to wounded Civil War soldiers, it has since been established as quite common (1). Over 70% of amputees report phantom limb pain for years after amputation (2). Several theories have been proposed regarding PLP, although there is still much to be

The earliest hypothesis regarding the cause of phantom limbs and pain was that of neuromas. These were thought to be nodules comprised of remaining nerves located at the end of the stump. These neuromas presumably continued to generate impulses that traveled up the spinal cord to portions of the thalamus and somatosensory domains of the cortex. As a result, treatment involved cutting the nerves just above the neuroma in an attempt to interrupt signaling at each somatosensory level (5). This and other related theories were deemed unsatisfactory because of the fact the phantom pain always returned, indicating that there was a more complex reason.

The cause of complex regional pain syndrome is unknown and many causes of CRPS occurs after a forceful trauma to an arm or a leg, such as crush injury, fracture, amputation, surgery, infections etc. Usually the distal limbs are affected. Single limb in the early stages, lower limbs in the children and upper limbs in adults1-2

Phillip C. is 5 months post and presents with severe left hemiplegia of the arm along with left leg paresis. The most recent neuropsychology assessment revealed deficits including: impaired hemi spatial neglect, impaired selective attention, flat affect, impaired affective auditory comprehension, disturbance of emotional facial recognition, problems with working memory, and problems with reduplicative paramnesia.

Nerve injury is not fatal but can severely impact quality of life. Peripheral nerve injuries occur in an estimated 2-3% of all patients admitted to a Level 1 trauma center (1) and are commonly caused by trauma to the upper limbs. The economic impact of nerve injuries can be large with operative costs, hospital charges, rehabilitation visits, and lost time at work. Only subtle improvements to peripheral nerve repair have been made recently, and our current knowledge of nerve physiology and regeneration vastly exceeds our current repair capabilities.

Modern prosthetic limbs have become very advanced in the last decade. They now have the ability to grip objects, have running limbs, and many more wonderful things. Although these prosthetics are great, they are lacking some key extras that amputees would relish. What amputees really want is their sense of feeling back. They want to reach out with their prosthetic limb and be able to tell if the stove is on or off. They want to be able to press the gas of an automobile. This sense, that all non-amputees take for granted, would be a great place to start the improvement of the perfect prosthetic limb. To accomplish such a daunting task, engineers must figure out an alternative source that could interact with the amputees still intact nerve endings. This way they can use their still functioning nerves to communicate with their pseudo-nerve and have the ability to move their prosthesis around with complete control of it and its sense of touch. I believe this has not

Sacks discussed the ideas behind the phantom limb and how they affected many peoples live. The most interesting story was about a sailor that accidentally cut off his index finger. For forty years he thought he would poke himself in the eye whenever he moved his hand to his face. One day he lost the feeling in his entire hand including his phantom finger and his problem was cured (Sacks 66-67). Up to 70 percent of amputees confirmed that they still feel or still thought a missing limb was there. They often feel that they can reach out and grab something. Some won't sleep in a certain way because they feel the missing limb between them and the mattress. The sensations felt stem from the activity of the sensory axons

Diagnosis of proximal suspensory desmitis (PSD) can be challenging (Dyson and Genovese, 2011). Local anaesthesia of the deep branch of the lateral plantar nerve (DB-LPN) was performed to assist with diagnosis in this case. Nerve blocks are not considered completely diagnostic for PSD as other surrounding structures are likely to be blocked following a single injection to block the DB-LPN (Hinnigan et al., 2014). However, the significant improvement in lameness shown in response to the block in this case was highly suggestive of PSD. Incidence of bilateral hindlimb PSD is much greater than in the forelimbs (Dyson and Genovese, 2011).

PMPS can develop shortly after surgery or may be delayed up to several months and can persist for years if it left untreated. The pain is often described as a neuropathic pain and is usually felt in the region innervated by the affected nerves. The exact mechanism is uncertain, but is thought to be the result of damage to nerve pathways, particularly the intercostobrachial nerve (lateral cutaneous branch of T2), during operative procedures on the breast and/or axilla

A historical perspective and classification of OBPP was first described by the Scottish obstetrician William Smellie in an article for midwives in 1764 [1] He documented the observation of resolution of bilateral upper extremity paralysis in a child with face presentation at birth. Danyau performed an autopsy of a newborn with brachial plexus palsy in 1851, providing the first anatomic description of this lesion.[2] but classic description of shoulder paralysis, internal rotation contracture and waiter’s tip deformity was given by Erb in 1874 as cited by Gilbert A et al. [3,4]. Duchenne and Balliere and Erb described cases of upper trunk nerve injury, attributing the findings to traction on the upper trunk, now called Erb’s palsy (or Duchenne-Erb’s palsy).[5]