Display options
Cite
Bultitude JH, Rafal RD. Derangement of body representation in complex regional pain syndrome: report of a case treated with mirror and prisms. Exp Brain Res. 2009;204(3):409-18doi: 10.1007/s00221-009-2107-8.
Bultitude, J. H., & Rafal, R. D. (2010). Derangement of body representation in complex regional pain syndrome: report of a case treated with mirror and prisms. Experimental brain research, 204(3), 409-18. https://doi.org/10.1007/s00221-009-2107-8
Bultitude, Janet H, and Rafal, Robert D. "Derangement of body representation in complex regional pain syndrome: report of a case treated with mirror and prisms." Experimental brain research vol. 204,3 (2010): 409-18. doi: https://doi.org/10.1007/s00221-009-2107-8
Bultitude JH, Rafal RD. Derangement of body representation in complex regional pain syndrome: report of a case treated with mirror and prisms. Exp Brain Res. 2010 Jul;204(3):409-18. doi: 10.1007/s00221-009-2107-8. Epub 2009 Dec 06. PMID: 19967390; PMCID: PMC2895899.
Copy Download .nbib Format: NLM
Share it on

Exp Brain Res. 2010 Jul;204(3):409-18. doi: 10.1007/s00221-009-2107-8. Epub 2009 Dec 06.

Derangement of body representation in complex regional pain syndrome: report of a case treated with mirror and prisms.

Experimental brain research

Janet H Bultitude, Robert D Rafal

Affiliations

  1. Wolfson Centre for Clinical and Cognitive Neuroscience, School of Psychology, Bangor University, Brigantia Building Penrallt Road, Bangor, Gwynedd, LL57 2AS, UK. [email protected]

PMID: 19967390 PMCID: PMC2895899 DOI: 10.1007/s00221-009-2107-8

Abstract

Perhaps the most intriguing disorders of body representation are those that are not due to primary disease of brain tissue. Strange and sometimes painful phantom limb sensations can result from loss of afference to the brain; and Complex Regional Pain Syndrome (CRPS)-the subject of the current report-can follow limb trauma without pathology of either the central or peripheral nervous system. This enigmatic and vexing condition follows relatively minor trauma, and can result in enduring misery and a useless limb. It manifests as severe pain, autonomic dysfunction, motor disability and 'neglect-like' symptoms with distorted body representation. For this special issue on body representation we describe the case of a patient suffering from CRPS, including symptoms suggesting a distorted representation of the affected limb. We report contrasting effects of mirror box therapy, as well as a new treatment-prism adaptation therapy-that provided sustained pain relief and reduced disability. The benefits were contingent upon adapting with the affected limb. Other novel observations suggest that: (1) pain may be a consequence, not the cause, of a disturbance of body representation that gives rise to the syndrome; (2) immobilisation, not pain, may precipitate this reorganisation of somatomotor circuits in susceptible individuals; and (3) limitation of voluntary movement is neither due to pain nor to weakness but, rather, to derangement of body representation which renders certain postures from the repertoire of hand movements inaccessible.

References

  1. Brain Inj. 2003 Aug;17(8):665-74 - PubMed
  2. Arch Phys Med Rehabil. 1998 Apr;79(4):424-9 - PubMed
  3. Spinal Cord. 2003 Feb;41(2):61-75 - PubMed
  4. Neuropsychologia. 2008 Mar 7;46(4):1069-80 - PubMed
  5. Neurology. 2004 Aug 24;63(4):693-701 - PubMed
  6. Pain. 2004 Aug;110(3):756-761 - PubMed
  7. J Hand Ther. 2000 Oct-Dec;13(4):260-8 - PubMed
  8. Pain. 1995 Oct;63(1):127-133 - PubMed
  9. Neurology. 2003 Jun 10;60(11):1829-31 - PubMed
  10. Cortex. 2002 Jun;38(3):309-20 - PubMed
  11. Neuropsychologia. 2004;42(12):1697-702 - PubMed
  12. Pain. 2000 Dec 1;88(3):259-266 - PubMed
  13. Rheumatology (Oxford). 2003 Jan;42(1):97-101 - PubMed
  14. Neuropsychologia. 2002;40(3):327-34 - PubMed
  15. Mediators Inflamm. 2002 Feb;11(1):47-51 - PubMed
  16. Rheumatology (Oxford). 2008 Nov;47(11):1612-6 - PubMed
  17. Int J Rehabil Res. 2007 Jun;30(2):181-8 - PubMed
  18. Clin Orthop Relat Res. 2007 May;458:35-9 - PubMed
  19. Nature. 1995 Oct 12;377(6549):489-90 - PubMed
  20. Arch Phys Med Rehabil. 2004 Apr;85(4):557-66 - PubMed
  21. Neurology. 2007 Jan 9;68(2):128-33 - PubMed
  22. Clin Rheumatol. 1988 Jun;7(2):173-80 - PubMed
  23. Brain Dev. 1996 Jul-Aug;18(4):257-62 - PubMed
  24. J Korean Med Sci. 2008 Oct;23(5):772-5 - PubMed
  25. Ann Vasc Surg. 1994 Jul;8(4):372-9 - PubMed
  26. Curr Biol. 2008 Nov 25;18(22):R1047-8 - PubMed
  27. Clin J Pain. 1992 Dec;8(4):287-99 - PubMed
  28. Neurology. 2003 Dec 23;61(12):1707-15 - PubMed
  29. Pain. 1995 Oct;63(1):11-20 - PubMed
  30. Pain. 2007 Dec 15;133(1-3):111-9 - PubMed
  31. Rheumatology (Oxford). 2003 Sep;42(9):1067-73 - PubMed
  32. J Appl Physiol Respir Environ Exerc Physiol. 1984 Sep;57(3):619-33 - PubMed
  33. Surg Clin North Am. 1946 Jun;26:780-90 - PubMed
  34. Pain. 2005 Aug;116(3):213-219 - PubMed
  35. JAMA. 1982 Sep 10;248(10):1203-8 - PubMed
  36. Lancet. 1993 Oct 23;342(8878):1012-6 - PubMed
  37. Neurology. 2001 Dec 26;57(12):2283-9 - PubMed
  38. Nature. 1998 Sep 10;395(6698):166-9 - PubMed
  39. Pain. 2007 May;129(1-2):12-20 - PubMed
  40. Neurology. 2005 Sep 13;65(5):773 - PubMed
  41. Ann Neurol. 2005 Mar;57(3):425-9 - PubMed
  42. Pain. 2008 Oct 15;139(2):239-240 - PubMed

MeSH terms

Publication Types

Grant support