Buonocore Michelangelo
Michelangelo Buonocore, Unit of Clinical Neurophysiology and Neurodiagnostic Skin Biopsy, Fondazione Salvatore Maugeri, Scientific Institute of Pavia, 27100 Pavia, Italy.
World J Clin Cases. 2015 Jul 16;3(7):542-4. doi: 10.12998/wjcc.v3.i7.542.
The term phantom sensations (PS) refers to sensations in a missing body part. They are almost universal in amputees and can be both painful and not painful. Although PS have been frequently described in limb amputees, they can also occur in other clinical conditions and several pathophysiological interpretations have been proposed, with a predominance of theories based on a central origin. Actually, different mechanisms are able to create a phantom sensation. After an amputation, PS are frequently generated by the genesis of ectopic action potentials in the interrupted nerve fibers but the PS generator can also be more proximal. Sometimes PS are not created by the stimulation of somatosensory fibers with a missing territory, but they can be the result of central sensitization or neuroplastic changes that allow for the convergence of impulses coming from different body parts (referred sensations), one of which is missing. In conclusion, PS can be generated by both neuropathic and non-neuropathic mechanisms developed in the amputated body part or in other parts of the nervous system. Since these mechanisms are not pathognomonic of amputation there are no hidden ghosts to look for in phantom sensations. The only interpretative rule is just to follow the pathophysiological principles.
幻肢感觉（PS）一词指的是在缺失的身体部位所感受到的感觉。它们在截肢者中几乎普遍存在，可能会伴有疼痛，也可能没有疼痛。虽然幻肢感觉在肢体截肢者中经常被描述，但它们也可能出现在其他临床情况下，并且已经提出了几种病理生理学解释，其中基于中枢起源的理论占主导地位。实际上，不同的机制都能够产生幻肢感觉。截肢后，幻肢感觉通常是由中断的神经纤维中异位动作电位的产生引起的，但幻肢感觉的产生源也可能更靠近近端。有时，幻肢感觉并非由感觉缺失区域的躯体感觉纤维受到刺激而产生，而是中枢敏化或神经可塑性变化的结果，这些变化使得来自不同身体部位（牵涉性感觉）的冲动能够汇聚，其中一个身体部位是缺失的。总之，幻肢感觉可以由截肢身体部位或神经系统其他部位发生的神经病理性和非神经病理性机制产生。由于这些机制并非截肢所特有的，所以在幻肢感觉中不存在需要寻找的隐藏幽灵。唯一的解释规则就是遵循病理生理学原理。
