Phantom pain in bilateral upper limb amputation.
OBJECTIVE
To alert health professionals on presence and extent of phantom pain and sensation following bilateral upper limb amputation.


METHODS
Of a total of 140 war-related bilateral upper limb amputees in Iran, 103 subjects were thoroughly examined in this cross-sectional study by a physical medicine specialist. The patients were questioned for the presence of phantom pain and sensations, and frequency and intensity of the feeling were recorded.


RESULTS
At 17.1 +/- 6.1 years after injury, 82.0% of the 103 amputees suffered from phantom sensation, including varying degrees of phantom limb pain in 53.9% of stumps. Phantom phenomena had a higher frequency in the right extremities, but this was not statistically significant (p > 0.01). Of those amputees who had phantom pain or sensation, 51.2% reported that they 'always' had phantom limb sensation; and approximately one-fourth of the subjects (24.6%) 'always' had phantom pain. Among the stumps who reported phantom pain (N=112), the pain was excruciating (38.5%), distressing (34.9%) or discomforting (25.6%). A significant statistical relation between phantom limb sensation and level of amputation was observed (p < 0.01).


CONCLUSIONS
At this time there is no healing for phantom pain; medical and surgical modalities only bring temporary relief, and less than 1% of the respondents achieve permanent relief through different treatment methods.
Modirian
Ehsan
E
Janbazan Medical and Engineering Research Center, Tehran, Iran. e_modirian@jmerc.ac.ir
Shojaei
Hadi
H
Soroush
Mohammad Reza
MR
Masoumi
Mahdi
M
D000293:Adolescent; D000328:Adult; D000672:Amputation Stumps; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D010591:Phantom Limb / Q000453:epidemiology* / Q000628:therapy; D016896:Treatment Outcome; D034941:Upper Extremity / Q000293:injuries* / Q000601:surgery*; D014857:Warfare; D055815:Young Adult