Medical Does the phantom limb phenomenon apply to internal organs?

[Enuma_Elish]

The name "phantom limb" implies an external extension of the body. Has a similar phenomenon been reported for internal organs?

Thanks for any and all.

 

[zoobyshoe]

The name "phantom limb" implies an external extension of the body. Has a similar phenomenon been reported for internal organs?

Thanks for any and all.

Yes! Ramachandran reports a case where the pain of appendicitis did not stop after that organ was removed, and the patient refused to believe the surgery had been performed. That is reported briefly on page 24 of his book, Phantoms in the Brain. He doesn't cite a paper or source.

 

[WhoWee]

"Pain Memory" is another possibility.
http://www.sciencedaily.com/releases/2000/10/001030082926.htm

 

[Andy Resnick]

There's also "referred pain"

http://en.wikipedia.org/wiki/Referred_pain

 

[Moonbear]

Referred pain is the reason this is a hard question to answer, because technically, all sensation from internal organs is "phantom pain." This is because the nerves supplying the internal organs form plexuses (think spider web instead of straight wire) and join in ganglia and then sometimes travel some distance before joining with the spinal cord. You get a lot of crossed signals. For example, someone with a ruptured spleen may feel shoulder pain, and most people know the classic example of someone having a heart attack feeling the pain down their left arm.

 

[zoobyshoe]

Referred pain is the reason this is a hard question to answer, because technically, all sensation from internal organs is "phantom pain." This is because the nerves supplying the internal organs form plexuses (think spider web instead of straight wire) and join in ganglia and then sometimes travel some distance before joining with the spinal cord. You get a lot of crossed signals. For example, someone with a ruptured spleen may feel shoulder pain, and most people know the classic example of someone having a heart attack feeling the pain down their left arm.

I think this would mean he never had appendicitis to begin with, though, that the pain was being referred there from somewhere else. However, the exact quote, which I should probably have posted earlier, reveals the quality of the pain to be specific to appendicitis:

Here's the exact quote from Ramachandran:

"In addition to phantom arms and legs - which are common among amputees - I had also encountered women with phantom breasts after radical mastectomy and even a patient with a phantom appendix: the characteristic spasmodic pain of appendicitis did not abate after surgical removal, so much so that the patient refused to believe that the surgeon had cut it out! As a medical student I was just as baffled as the patients themselves, and the textbooks I consulted only deepened the mystery. I read about a patient who experienced phantom erections after his penis had been amputated, a woman with phantom menstrual cramps following hysterectomy, and a gentleman who had a phantom nose and face after the trigeminal nerve innervating his face had been severed in an accident."

pp. 24-25

Incidentally, he treats the subject of phantom pain as a separate issue from other phantom sensations believing that the mechanism is different.

 

[zoobyshoe]

Apropos, this occurred to me: Teeth have nerves, many people have teeth extracted, but I have never heard of a report of Phantom Teeth

 

[DaveC426913]

Apropos, this occurred to me: Teeth have nerves, many people have teeth extracted, but I have never heard of a report of Phantom Teeth

I wonder though, if this is slightly different due to the fact that the teeth are in intimate contact with the tongue and cheek and with other teeth. That may be where the sensations are expected.

 

[zoobyshoe]

I wonder though, if this is slightly different due to the fact that the teeth are in intimate contact with the tongue and cheek and with other teeth. That may be where the sensations are expected.

Ramachandran had a guy whose arm was gone just below the elbow. Since the hand and face are right next to each other on the sensory strip, facial neurons took over the space vacated by the missing hand. That's not rigorously stated but what it means is that when his face was touched he felt touch both on his face and on the phantom hand.

I did some googling, but I can't find where the teeth are represented on the sensory strip so it's not clear that the tongue and cheeks should automatically take over the sensory strip space vacated by the teeth.

 

[blant009]

Does anyone know if ramachandran has a treatment for phantom organ pain? My mother has had chronic abdominal pain for 15 years due to acute pancreatitis. She had her pancreas removed two years ago and still experiences severe pain to this day. It sounds a lot like the phantom pain described by ramachrandran. If anyone has a lead as to how to treat the symptoms for phantom organ (not limb!) pain, my family would be forever indebted to you...

 

[Moonbear]

Ramachandran would not have a treatment for it. He just studies the mechanism. Zoobie's remarks are, as usual, misleading on the topic of neuroscience.

Phantom pain/sensations are what Ramachandran studies; he didn't "invent" the concept. It's not even his primary area of research.

What Zoobie alluded to, but didn't quite state, is the well-established idea that phantom sensations are happening at the level of the brain. Afterall, the receptors of the affected area have been removed along with the limb/organ.

Regarding internal organs, you don't actually feel an aching pancreas, for example. You feel pain in the back or abdominal wall. USUALLY the pain is referred to predictable places, but not always, because everyone has variations in their anatomy. And, the fact is that medical mistakes happen because of this.

Pain lasting 15 years is, by definition, NOT "acute." My first suggestion is before writing it off as phantom pain, find a new doctor and make sure the initial diagnosis was correct, the right organ removed, and that no other organs have been compromised. Also, is she carefully following the dietary restrictions that would follow pancreas removal?

 

[cuallito]

Apropos, this occurred to me: Teeth have nerves, many people have teeth extracted, but I have never heard of a report of Phantom Teeth

Well, to bring a thread back from the dead, I've got a phantom wisdom tooth. No kidding.

Found this thread on google because it wouldn't let me sleep a wink and I was trying to find something to do about it.

 

[WhoWee]

Well, to bring a thread back from the dead, I've got a phantom wisdom tooth. No kidding.

Found this thread on google because it wouldn't let me sleep a wink and I was trying to find something to do about it.

I have twins (boy/girl). My daughter is starting to experience real pain from her wisdom teeth - accordingly my son now also has "symptoms". Unfortunately, the only ones he can explain are the ones described by his twin.