Canavero S
Neurosurgical Clinic, Turin, Italy.
Med Hypotheses. 1994 Mar;42(3):203-7. doi: 10.1016/0306-9877(94)90101-5.
Central and phantom pains remain unexplained by current pathophysiological hypotheses. Newer theories suggest that these may be the result of an altered processing inside a network of neurons extending throughout wide-spread areas of the brain, precluding neurosurgical treatment. On the basis of a literature review of cases with spontaneous resolution of the pain, it is argued that both central and phantom pain depend on a localized corticothalamic reverberatory loop, which is at the basis of the steady components of both. In this case, selective stereotactic lesions of the corona radiata deep to the frontoparietal sensorimotor strip may achieve a permanent cure. This theory refutes the neuromatrix hypothesis of phantom phenomena. It is speculated that electroconvulsive therapy might block the pathologic reverberation in both central and phantom pains.
中枢性疼痛和幻肢痛目前的病理生理假说仍无法解释。新的理论认为，这些可能是在广泛分布于大脑各区域的神经元网络内部处理过程改变的结果，这使得神经外科治疗无法适用。基于对疼痛自发缓解病例的文献综述，有人认为中枢性疼痛和幻肢痛都依赖于局部皮质丘脑折返环路，这是两者稳定成分的基础。在这种情况下，对额顶感觉运动区深部的放射冠进行选择性立体定向损伤可能会实现永久治愈。该理论驳斥了幻肢现象的神经矩阵假说。据推测，电惊厥治疗可能会阻断中枢性疼痛和幻肢痛中的病理性折返。
