In the TV series "House" in the "Tyrant" series there is an unusually vivid scene - House heals a neighbor from an almost incurable disease - phantom pain - a disease that affects 80-90 percent of amputees.
This scene amazed not only because it was both scary and joyful, but also because behind this miracle there is a completely real practice - experimental, still not fully comprehended, but still quite effective.
Since there are almost no intelligible articles on this topic in Russian, I have compiled a small digest for you, mainly based on an article in the New Yorker. I am quite sure that it was she who served as the source for the story with the neighbor - the article was published in the spring, this magazine is very famous and read, so the connection is obvious to me.
Vilayamur Ramachandran, a physician of Indian descent, currently works at a University of California. He investigates many phenomena, including phantom pain, apotemnophilia (a rather rare disorder in which patients feel an uncontrollable desire to amputate their arm or leg), the consequences of a stroke, and more. Since we are interested in phantom pains, I will tell you exactly about them.
Phantom pain (that is, the sensation of pain, tension in the amputated limb) has been written about for a long time. As a rule, patients complain of a terrible tension that cannot be defused - for example, the feeling that the fist is clenched so that the nails dig into the palm. For some, these pains are so intolerable that people commit suicide. For about a hundred years, doctors believed that the cause of phantom pain was inflamed nerve endings (neuromas) left in the stump of an arm or leg. Some patients decided on repeated amputations, shortening the injured limb more and more. When that didn't work, they tried to block nerves in the spine and even neutralize segments of the thalamus (the base of the brain that processes pain signals). Nothing helped.
Ramadcharan argues that phantom sensations are generated by the interaction of sensory and motor areas of the cerebral cortex, as well as the "body map", which is located in the right section of the cortex, just above the right ear. One of the main tasks of this section is the formation of a complete body image obtained from touch ("I touch the cup with my fingers"), visual signals ("I see my hand touching the cup") and signals emanating from muscles, ligaments and muscles (“I can feel my hand reaching for the cup”). Although amputees do not receive these signals, Ramadcharan believes that memories of them are stored in both the brain and nervous system. In the process of studying the case histories of people suffering from phantom pain, he noticed that many of the corresponding part of the body was immobilized before the amputation (disease,plaster, dressing). As a result, a vicious circle is formed - in response to continuous impulses that come from the brain to the limb, the body receives visual and tactile evidence that the arm or leg cannot move. After amputation, a new "body map" is formed in the patient's brain, in which the feeling of paralysis or pain in the already amputated limb is "written". According to Ramachandran, all one has to do is "trick" the brain by showing it that the arm or leg is still in place and can be moved.in which the feeling of paralysis or pain in the already amputated limb is "written". According to Ramachandran, all one has to do is "trick" the brain by showing it that the arm or leg is still in place and can be moved.in which the feeling of paralysis or pain in the already amputated limb is "written". According to Ramachandran, all one has to do is "trick" the brain by showing it that the arm or leg is still in place and can be moved.
His first patient was a young man who had an accident that left his left arm paralyzed. He walked with a sling for a year and then agreed to amputation. Since then, he did not leave the feeling that his hand was numb, in an uncomfortable position. Ramachandran set up an ordinary mirror so that it was vertical and perpendicular to the young man's body. He asked to put his good hand on one side of the mirror, and the stump on the other. The patient looked at the reflection of his healthy hand - so that he created the illusion that this hand was in fact an extension of his amputated limb. Then Ramachandran asked the person to move his hands synchronously - up and down, without taking his eyes off the mirror. "Oh my God! - the patient exclaimed, - Oh, God, doctor, this cannot be! " For the first time in ten yearsthe patient felt his phantom hand "move" and the pain finally subsided. After that, the patient underwent mirror therapy for 10 minutes a day for a month and gradually his phantom hand disappeared, and with it the phantom pain disappeared. “For the first time,” Ramachandran later wrote, “we can talk about the successful amputation of a phantom limb.”
Ramachandran conducted an experiment on eight more patients, and all but one of them unclenched their fists, straightened the muscles in their phantom arms. Subsequently, this experiment was repeated by an independent group of researchers in England, as the technique of "mirror therapy" caused skepticism and rejection of doctors. Of the 18 people with phantom pain, six underwent mirror therapy, while the rest underwent other methods (closed mirror and visualization). As a result, in the control group, only three patients improved slightly, while in all the others the pain increased. Six patients undergoing mirror therapy had no pain at all.
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Now back to House. According to the veteran, he has been suffering from phantom pain for many years - and, like real patients, he is tormented by the feeling of a fist clenched to a spasm. House, as expected, acts radically - attacks him, ties him up, and forces him to shove his hands into some kind of box.
This is the same "mirror box" that Ramachandran invented and is widely used in mirror therapy. The veteran puts his hands in, sees a whole hand in place of his stump. "Now, let go, open your fist," House says.
And the pain, the tension that tormented a person for many years, goes away. According to research, the effect of mirror therapy may be immediate; however, it is recommended to repeat these sessions several times so that the pain disappears completely. Ramachandran himself says that in his practice, a third of patients are completely free of pain. However, he warns that if the amputation occurred ten or more years ago, therapy may not work.
Also, my opinion is that I don't think that such quick relief is possible when a person is as scared and shocked as House's forced patient.