Utente:Vale maio/Sandbox5: differenze tra le versioni
Contenuto cancellato Contenuto aggiunto
Riga 27:
== Pathogenesis ==
===Sensazioni fantasma dolorose e non===
</ref>. La sindrome dell'occhio fantasma è molto meno comune della [[sindrome dell'arto fantasma]]. Dopo l'[[amputazione]] di un arto, la percentuale dei pazienti che lamentano tale sindrome è tra il 50% e il 78%, mentre nel caso di perdita di un occhio, la percentuale scende a circa il 30%.
Si pensa che le sensazioni dolorose e non agli arti mancanti siano dovuti a cambiamenti post-amputazione nella [[omuncolo motorio|rappresentazione corticale delle parti del corpo]] adiacenti all'arto amputato. Una ragione per la minore incidenza di casi di occhio fantasma si pensa possa essere la rappresentazione corticale [[tattile]] più piccola dell'occhio, in confronto alla rappresentazione degli arti.
Alcuni studi
=== Phantom pain and non-painful phantom sensations ===
▲Phantom pain and non-painful phantom sensations result from changes in the central nervous system due to denervation of a body part.<ref name="Ramachandran">{{cite journal |first=Vilayanur S. |last=Ramachandran |authorlink=Vilayanur S. Ramachandran |coauthors=W Hirstein |title=The perception of phantom limbs. The D. O. Hebb lecture |journal=[[Brain (journal)|Brain]] |volume=121 |issue=9 |pages=1603–30 |year=1998 |month=September |pmid=9762952 |doi= 10.1093/brain/121.9.1603|url=http://brain.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=9762952 |accessdate=2008-09-23}}</ref><ref name="Nikolajsen">{{cite journal |first=L. |last=Nikolajsen |coauthors=T. S. Jensen |title=Phantom limb pain |journal=[[British Journal of Anaesthesia]] |volume=87 |issue=1 |pages=107–16 |year=2001 |month=July |pmid=11460799 |doi= 10.1093/bja/87.1.107|url=http://bja.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=11460799 |accessdate=2008-09-23}}</ref> Phantom eye pain is considerably less common than phantom limb pain. The prevalence of phantom pain after limb [[amputation]] ranged from 50% to 78%. The prevalence of phantom eye pain, in contrast, is about 30%.
In limb amputees, some<ref name="Nikolajsen">{{cite journal |author=Nikolajsen L, Ilkjaer S, Krøner K, Christensen JH, Jensen TS |title=The influence of preamputation pain on postamputation stump and phantom pain |journal=Pain |volume=72 |issue=3 |pages=393–405 |year=1997 |month=September |pmid=9313280 |doi= 10.1016/S0304-3959(97)00061-4|url=http://linkinghub.elsevier.com/retrieve/pii/S0304395997000614 |accessdate=2008-09-23}}</ref> but not all studies have found a correlation between preoperative pain in the affected limb and postoperative phantom pain. There is a significant association between painful and nonpainful phantom experiences and preoperative pain in the symptomatic eye and [[headache]].<ref name="Nicolodi">{{cite journal |first=M. |last=Nicolodi |coauthors=R. Frezzotti, A. Diadori, A. Nuti and F. Sicuteri |title=Phantom eye: features and prevalence. The predisposing role of headache |journal=Cephalalgia |volume=17 |issue=4 |pages=501–4 |year=1997 |month=June |pmid=9209770 |doi= 10.1046/j.1468-2982.1997.1704501.x|url=http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0333-1024&date=1997&volume=17&issue=4&spage=501 |accessdate=2008-09-23}}</ref> Based on the present data it is difficult to determine if headaches or preoperative eye pain play a causal role in the development of phantom phenomena, or if headache, preoperative eye pain, and postoperative phantom eye experiences are only epiphenomena of an underlying factor. However, a study in humans demonstrated that experimental pain leads to a rapid reorganization of the [[somatosensory cortex]].<ref name="Soros2">{{cite journal |first=Peter |last=Sörös |coauthors=Stefan Knechta, Carsten Bantelb, Tanya Imaia, Rainer Wüstenb, Christo Pantevc, Bernd Lütkenhönerc, Hartmut Bürkleb and Henning Henningsen |title=Functional reorganization of the human primary somatosensory cortex after acute pain demonstrated by magnetoencephalography |journal=Neuroscience Letters |volume=298 |issue=3 |pages=195–8 |year=2001 |month=February |pmid=11165440 |doi= 10.1016/S0304-3940(00)01752-3|url=http://linkinghub.elsevier.com/retrieve/pii/S0304394000017523 |accessdate=2008-09-23}}</ref> This study suggests that preoperative and postoperative pain may be an important cofactor for somatosensory reorganization and the development of phantom experiences.
|