Algohallucinose : à propos de 18 cas

The algohallucinosis is defined by the pain of an amputated limb. This is a relatively common complication after amputation. Its therapeutic management is difficult and generally disappointing. Through this retrospective study of 18 patients seen at pain center, La Rabta, Tunis, we will describe the different characteristics of the algohallucinosis. We specified the epidemiological and clinical data. The average age of our patients was 58 years; the average age at first consultation was 48 years, ranging from 27 to 90 years. The causes of amputation were diverse. The average time to onset of pain was one year and three months. Algohallucinosis associated to stump pain were noted in 8 patients. Types of pain were dominated by burns and electric shocks. The DN4 was superior to 4/10 in all cases. Reactive depression was detected in 61% of cases. All patients were put on combination therapy. Psychotherapy was started in 9 patients (50%). Improvement was noted in 14 patients. The algohallucinosis is common (60-85% of patients). The algohallucinosis, phantom sensations and stump pain overlap and, in the same patient, the three phenomena often coexist. Pathophysiologically, several theories are issued. Treatment is based on common treatment recommendations for neuropathic pain. Non-pharmacological approaches are possible. Individualized accommodation is the rule.