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Phantom
limb cramp is attributed to the arm nerves affected by the amputation and skin
in the face; which can be effectively eliminated by peripheral nerve block.
Central pathways, especially primary sensorimotor areas, exhibits the potential to intensify and modulate the quality of cramping in phantom limb pain, as per the findings of a study and case report published in 'Experimental Brain Research'.
Phantom limb pain is a condition in a substantial number of amputees with varying characteristics of pain and restriction. A forearm amputee was reported with constant phantom pain in hand, in whom it regularly elicit the rare phenomenon of referred cramping phantom pain by touching the face.
To
clarify the underlying mechanisms, it followed the cramp during an axillary
blockade of the brachial plexus. During the blockade, both phantom pain and the
referred cramp were abolished, while a referred sensation of “being touched at
the phantom” persisted. Furthermore, to identify the cortical substrate,
elicited the cramp during functional magnetic imaging. Imaging revealed that
referred cramping phantom limb pain was associated with brain activation of the
hand representation in the primary sensorimotor cortex.
The
results and findings supported the hypothesis which formerly said that in this
case, the cramping phantom limb pain, is associated with substantial brain
activation in the hand area of the deafferented sensorimotor cortex. But, this
alone is not adequate to elicit referred cramping phantom limb pain. The
peripheral inputs, from the arm nerves affected by the amputation and from the
skin in the face at which the involved cramp is evoked revealed that these may
be the preconditions for referred cramping phantom limb pain to occur.
Experimental Brain Research
Referred cramping phantom hand pain elicited in the face and eliminated by peripheral nerve block
Dietrich C. et al.
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