Capgras Syndrome Chapter 1 Summary

In this chapter, author introduces us to one of the fascinating neuroplastician, V.S. Ramchandran. Even in this high tech world, he seems to be connected with nineteenth century machine. Later he grew up his passion on things like paleontology, conchology, entomology, and botany. In his beginning year in research, he studies about the patients with mental illusions suffering from Capgras syndrome and later he figure out how the normal brain works.
He is the first one to solve the mystery of phantom limbs and the chronic pain they engender. It was believe that 95% of amputees end up having phantom pain. It was difficult for doctors’ cause they had no known source in the body to treat. There were patients who got their uterus removed but they
still can feel the menstrual cramps and labor pain. Patients who felt ulcer pain even the nerve been cut out. Even body healed, the presence of the pain system is still firing causing patient to feel acute pain. It was Silas Weir Mitchell who proposed “The Phantom Limb.” During Civil war solider wounded arms and legs were amputate and later they complained that their limbs has returned to haunt them. At that time, Doctor thought it was patients’ imagination because of their denial of lost of a limb. Even Doctor tried serial amputation, so the patient would not feel the phantom pains but it didn’t work.
Ramchandran came across the idea that patients with Phantom pain and Taub’s monkeys have some similarity. He believed that the face maps of amputees cross the maps for the missing arms, so when his patient touch their face they can sense the touch in their phantom limbs.
Ramchandran worked with the patient named Tom Soreson, who lost his arm in an automobile accident.
After 4 weeks, he start getting sense of the phantom limb even it was not there. Ramchandran found out that Tom’s hand and face maps merged together. So when Ramchandran put a drop of warm water on Tom’s face, Tom felt it on his Phantom hand. So the reason for the patient to have phantom pain is that when a limb is cut off, its map gets distorted but also invades other map in the brain. After examining several amputees, he found out that half of them had the unpleasant feeling that their phantom limbs are frozen, or paralyzed. During his examination, he came across to the patient who still had the excruciating pain in the present. As we know, when brain sends out the signals to move the arm, the brains gets feedback from the different senses but due to the absence of the arm never gets signals that arms has been moved, since there is no signal back to the brain. Thus the person feels as their phantom arms frozen or paralyzed.
So Ramchandran came with the idea of sending the false signal to the brain to make patient believe that their missing limb is moving. Ramchandran came up with the idea to use mirror box that create the mirror image of the good arm so when they see their good arm moving in the mirror they thought it’s the phantom arm. The idea of using the mirror image is to reorganized the motor maps for the phantoms and stabilize the sensory system. His mirror box therapy
cure the phantom pain and help to understand how our minds work during pain.
Further Wall and Melzack describe the pain that we feel when we hurt our one body part but feel the pain in another. When pain signals coming from the injured part of the body get altered in the spinal cord and as the map change, pain signals merge with the adjacent pain maps causing “referred pain.” After this they came up with new treatments for blocking pain, which was similar to the acupuncture where it blocks the pain perception by closing gates. On the basis on the Wall and Melzack gate theory, Ramchandran developed his own theory that pain is an illusion where as our mind is like a virtual machine so it would be exceptional if he can cure chronic pain just by using patients’ imagination and illusion so as to rearrange brain maps plastically without any medications, acupuncture or electricity.