The findings described here indicate that a series of mechanisms are involved in generating phantom pains, and that these include elements in the periphery, spinal cord, thalamus, and cerebral cortex. It is likely that the first events occur in the periphery, which subsequently generates a cascade of events that sweeps more centrally, finally recruiting cortical brain structures. The latter may be responsible for the complex and vivid sensations that characterize certain phantom pain sensations. Figure 31.3 shows a proposed model for the development of phantom pain.

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