Thursday, September 15, 2011
Phantoms in the Brain - V.S. Ramachandran - A Review
When i was attending the valuation class taken by Mr. Damodaran, he gave a strange but an interesting analogy to pinpoint the misplaced concreteness in identifying flaw or the loopholes in the financial statements, he asked us, how does one treat the itching sensation on his amputated thumb?
Now, this question triggered two more questions within me.
1. How can someone possibly feel the itch on a nonexistent thumb?
2. If that really is the case then how do you go about your treatment on something that’s nonexistent?
Phantoms in the brain, written by Ramachandran, tries to enlighten us to those questions and a lot more syndromes that we didn’t even know exists.
This is a syndrome which is identified as Anosognosia, the inability of your brain to perceive the absence of some or any part of your body. It was common amongst soldiers who lost their limbs in the civil war but could still feel the presence of their lost limbs. We can call them ‘Phantom limbs’ for easy identification.
At times, these patients come to the doctors claiming that they feel extreme pain in those phantom limbs. Now, the challenge is not just diagnosis but also the treatment of a nonexistent limb. Initially, the surgeons tried to remove the entire stump of the amputated limb, so that the brain begins to understand its absence but such a surgery didn’t help much in relieving in the pain. Many more drastic surgeries were tried to no avail.
Hence the doctors touched each and every part of the patients body and enquired the patient on the exact location where the patient felt the touch. To their astonishment, they found that the pain in the lost limbs was caused by a few areas near the face. When the doctor dragged a pen on the face of the patient, it was felt on the skin of the lost limb. Such a diagnosis not just puzzled them but threw them into unchartered territories on neurology.
The reason cited behind such a syndrome is that there are about 30 different divisions in the brain that identifies different parts of the body, the region that identifies a few areas of the face falls right next to the region that identifies the limbs. Hence when a limb is lost there happens to be an invasion of territory and hence the area of the face and the limbs are merged into a single entity leading to a faulty geographic identification of pain by the brain.
Now, how do you rectify such a syndrome is a different story all together.
There are many more syndromes that are discussed in the book and are truly mind-blowing.
Like, Hemineglect, patients who neglect the left side of their body completely. They comb only the right side, eat only on the right side of the plate and many more. This happens due to damage on the right parietal lobe.
Something that really put me off my chair was Psuedocyesis, which in understandable terms is called Phantom Pregnancy. Here the patient develops all the signs and symptoms of true pregnancy, like frequent headache, nausea, their stoppage of menstruation cycle, morning sickness, tummy getting inflated and to kick it off, they feel labour pain in about 9 months. Puzzling, isn’t it?
In 1700’s these cases happened in the ratio of 1 in 200 but now ratio has plunged down to 1 in 10,000. The reason being that the pressure to deliver babies has been reduced drastically and the numbers has reflected just that.
Ramachandran has made lot many more clinical observations and the same has been reflected in his book. Guess we can’t expect anything less from a Phd in Neurology, Professor and Director, Center for Brain and Cognition, University of California and many more recognitions under his name plate.
Finally, to answer my second question, just scratch the surface below the jaw.