DYNAMIC REVERBERATION - A UNIFIED MECHANISM FOR CENTRAL AND PHANTOM PAIN

Central and phantom pains remain unexplained by current pathophysiolog ical hypotheses. Newer theories suggest that these may be the result o f an altered processing inside a network of neurons extending througho ut wide-spread areas of the brain, precluding neurosurgical treatment. On the basis of a literature review of cases with spontaneous resolut ion of the pain, it is argued that both central and phantom pain depen d on a localized corticothalamic reverberatory loop, which is at the b asis of the steady components of both. In this case, selective stereot actic lesions of the corona radiata deep to the frontoparietal sensori motor strip may achieve a permanent cure. This theory refutes the neur omatrix hypothesis of phantom phenomena. It is speculated that electro convulsive therapy might block the pathologic reverberation in both ce ntral and phantom pains.