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Phantom limb sensations and phantom limb pain in child and adolescent amputees
Krista L Wilkins1, Patrick J McGrath, Allen G Finley
1Pain Research Laboratory, Department of Psychology, Dalhousie University, Halifax, Nova Scotia B3H 4J1, Canada Department of Psychology, Psychiatry, Pediatrics and Occupational Therapy, Dalhousie University, Halifax, Nova Scotia B3H 4J1, Canada Department of Anaesthesia, IWK Grace Health Centre and Dalhousie University, Halifax, Nova Scotia B3J 3G9, Canada Department of Psychology, Toronto Hospital, Acute Pain Research Unit and Department of Anaesthesia, The Toronto Hospital and Mount Sinai Hospital, Departments of Public Health Sciences and Anaesthesia, University of Toronto, Toronto, Ontario, Canada.
Objective:
To provide a better understanding of the prevalence, correlates and quality of phantom sensations and phantom pain in child and adolescent amputees.
Design:
Retrospective survey study.
Setting:
Recruitment through the War Amputations of Canada.
Participants:
Sixty child and adolescent amputees aged 8-18 years who were missing a limb due to a congenital limb deficiency (n = 27) or surgery/trauma (n = 33).
Main Outcome Measure(S):
Questionnaire to assess the occurrence and correlates of phantom sensations and phantom pain.
Results:
Forty-two percent of the total sample reported phantom sensations; 7.4% of the congenital group and 69.7% of the surgical group (chi2 = 23.70 with 1 df, P < 0.01.) Twenty-nine percent of the total sample reported phantom pain; 3.7% of the congenital group and 48.5% of the surgical group (chi2 = 14.67, with 1 df, P < 0.01). Eighty-eight percent of the amputees with phantom pain had stump pain, while 35.3% had phantom pain that was similar to pre-operative pain and 76.5% experienced pains other than phantom pain (e.g. headaches). Amputees identified exercise, objects approaching the stump, cold weather and 'feeling nervous' as the primary triggers of phantom sensations and/or phantom pain.
Conclusion(S):
Less than half of the sample experienced phantom sensations and phantom pain; however, the loss of a limb due to surgery is associated with an increase in the likelihood of experiencing these phenomena.