Saturday, December 12, 2009

nothing you can think that is not the moon

it's been a messy day here in marlinspike hall, deep, deep in the tête de hergé (très décédé, d'ailleurs). the mess has involved miscommunication atop fatigue, and the way back seems to be along introspective paths.

instinctually, i turned to my brother-unit tw, man and photographer extraordinaire. a superb brother-unit, too.

sometimes a sister needs a brother, needs a god.

please remember that while i steal with impunity from one of his blogs, American Idyll -- *you* must write and ask permission for any reproduction of his work.

the photographs that spoke to me today were published monday, december 7 and do bear remarkable semblance to moonscapes. at least, the moonscapes that *i* have seen.

i'd rather learn
from one bird
how to sing
than teach
ten thousand stars
how not to dance.
--e.e. cummings

there is nothing
you can see that
is not a flower.
there is nothing
you can think that
is not the moon.

Lindsey Baum and the Belly of the Beast

It's frustrating to have only rumor and probable coincidence to report about missing 11-year-old Lindsey Baum.

Around 9:15 pm on June 26, Lindsey J. Baum, then a 10-year old from the tiny town of McCleary, Washington, disappeared while walking from a friend's house to her home, only four short blocks away. Two of those four blocks are reported to be somewhat industrial -- though we are talking *rural* small town.

One block away is access to a major highway.

She'd just had an argument with her brother, but most everyone notes that she wasn't storming off mad. She didn't have the accoutrements you'd think of when thinking of a runaway -- no money, no cell phone, no change of clothes.

Some friends set out with her, so she was accompanied for a while before they peeled off to go to their own homes for dinner, or homework, a bath or shower, whatever.

Despite an intensive police search including the FBI and high-tech tools, along with frequent weekend searches conducted with volunteers from her hometown -- the case remains unsolved.

Some housekeeping items:

Family, friends and law enforcement officials hope that raising the amount of the reward for information about Lindsey Baum will encourage tips in the case. Currently, the reward money amounts to $10,000. If you would like to help in this effort, donations for the reward can be mailed directly to Sterlings Savings Bank at the following address:

Lindsey Baum Reward Fund
P.O. Box 600
McCleary, WA 98557

[In a formal and highly scientific study, I compared, via statistics, the number of (tweeted) hits that two nearly identical statements about Lindsey received. The difference? One statement mentioned the reward, and the other did not. The remark including the monetary reward received approximately 20% more attention. I've conducted the "experiment" three times now, alternating the order of presentation and attempting to publish each statement quickly, one right after the other.]

Yesterday, a local news station,, updated an earlier story about what one hopes is a terrible coincidence involving Lindsey Baum's relatives:

OLYMPIA, Wash. - Relatives of Lindsey Baum, the McCleary 10*-year-old girl [*11]who vanished in June, called Olympia police last month to report a stranger in their backyard.

The homeowner said the man was crouching beneath the bedroom window of Baum's two female cousins, who are 9 and 12 years old.

Olympia Police said any connection between the two cases is coincidental, but Grays Harbor County investigators have been in touch with Olympia Detectives about the Nov. 13 incident.

Investigators in the Baum case have not identified any suspects in the girl's disappearance.

"It's scary," said Derric, the father of the girls who did not want his last name published. Derric said he and his wife were already nervous about their kids' safety after what happened to his niece.

"It even makes you more cautious about your own children," said Derric.

Olympia police have released a sketch of the suspect from the case in the backyard break-in. Detectives said the man may be responsible for two attempted luring cases in Olympia in November.

On Nov. 10, about eight blocks from the house where the man was seen, a man approached a 10-year-old girl and asked if she needed a ride. She ran home and police were contacted.

On November 24, about two miles from the home, a 9-year-old girl said a stranger asked her if she could help him load groceries into her car. She said no and ran away.

In both incidents, the man was reportedly driving a silver car.

Detectives said the girls did not think the man in the sketch released by police was the man that approached them, but police said it's possible he could be responsible for all three incidents.

When Derric confronted the man in his backyard , he asked what the man was doing. Derric said the man told him he was a building inspector. Derric said when he asked the man for his I.D., the man walked quickly to his car, and drove off. Derric told police the man was driving a silver Mazda.

[NOTE: The video at King5 TV site includes a sketch of the suspect (and the rather remarkable hole in his right ear lobe!)]

I will spare you the explicit details that the "forensic astrologists" have come up with, as well as the conclusions of a witch living in Japan who has been gifted with dreams containing the name of a suspect (or three). It is disconcerting to note the degree of specificity these folks manage to come up with, and how deftly they incorporate real factoids into their fictions. I have found myself with a racing heart, and hope near at hand, while reading their insights -- forgetting that I'm not dealing with people well-grounded in reality. What? Why, yes, I *do* have a slightly pejorative opinion of the occult arts. How ever did you know?

If the belly of the beast interests you, or if you just want to "learn how forensic astrology works and gathers critical details and key actions pertaining to crimes," visit the mentalists at Websleuths. If you are a practitioner, please leave a blank comment to help me understand...

The self-described "Eclectic Wiccan Pagan - Former U.S. Goth - Japanese Language Speaker," goes by the Twitter name of "ren1999 ." S/he also goes by Kira3696 on other sites. S/he coyly announced, back on 16 July: "I am a psychic detective working on the case of Lindsey Baum. No really. Did you know that about me?"

Ren1999 has deleted this tweet from 3 October, in which a suspect is identified. Soon thereafter, I believe, something was said about a vehicle, but I failed to copy that communication.

D*le Allen Walt*rs G*lder. His online nickname may be "Alice Waters" and possibly indicates he posted to missing Lindsey Baum's website.

Ren/Kira frequents the Wicca Online Community, where he has his own page with a profile name of "Jon Tomas." There, Ren/Kira has the assistance of one "Lady Ella HPS" and sidekicks "Catt" and "Pat P 53" -- who join in discussions about Lindsey in one of their forums.

I am not sure how {whistle::whistle}, but investigators are well aware of this individual. Of course, it is barbaric, the pain this sort of thing is causing for Lindsey's parents, family, and friends, not to mention the amount of time law enforcement has to waste in investigating these "findings" -- and their "finders." Because, of course, one's initial impulse is to wonder if these psychic sleuthes might not include the actual kidnapper, who is enjoying a bit of Twisted Sport.

Lady Ella, on 15 July:
MM A ten year old girl has been missing for over two weeks in McCleary Washington. I have gotten some visons about the situation, and they are being acknowleged, however we all got together for Purple Owl and had great results. Everyones help is needed desparately. do you think that we could put our differences aside amd do a spell to help find her, this has Nothing to do with me, but a child. Please soften your hearts and help find her ..............Blessed BE, The Lady Ella

Catt answers: Do they have anything to go on? Did anyone see anything. The more information I have the better. We could do a spell very like the one we did for Purple Owl. Does everyone remember what we did? You can go look at the discussion called Bring a Rapist to Justice. We just need to change the who and it will work the same. Do you think she is still alive? Do you think she was kidnapped or is she lost? I'll be happy to help.

Lady Ella ramps things up with: MM Appearently she left her friends house sometime after 9 pm and had to walk 4 blocks to her home, alone......She never made it home..........In my visions I saw an older model white van, the type with the doors on the back,,,,,,,,,,I saw woods and then I saw a body of water with a bridge spaning it.......Here's the best part, I saw a white male in his 30's, his head was shaved and he had a goatee. The shirt that he was wearing had the sleeves cut off. I can see his face a clear as day and could pick him out of a line-up or photo. Sadly, I don't think that the little girl is still alive. I also feel that this monster is known by the family...............This is all that I have gotten so far but I'll let you know if more should come to me. Thank You very much . Blessed Be, The Lady Ella

Anyway, it goes on. And on.

Ren/Kira fuels the fire, and soon the visions and suspects are, blessed be, practically climbing out of the woodwork. I confess to being especially defensive about ren1999's invocation of "Alice Waters," as I am a longtime fan of the lady, and her food!

In fact, let us pause in the abundance of our lives, and dégustons today's menu at Chez Panisse:

Saturday, December 12
An apéritif
Warm spiny lobster salad with cardoons and artichokes
Monterey Bay squid ragout pasta with zinfandel and leeks
Grilled rack, loin, and leg of James Ranch lamb in zinfandel sauce with roasted vegetables
and braised endives and greens
Meyer lemon soufflé

There is much more nonsense out there than I can stomach, and to have it be associated with the task of finding missing children makes it especially odious. Each time I post an "update," I make myself revisit these urchins, and sometimes find new visionaries and charlatans, all the while wondering if Lindsey Baum could even begin to fathom herself as the lead topic in the "Crones and Elders" section of an online Wiccan Community, Please note, I've nothing against wicca. I'm sure to have mentioned at some point that The Fredster is a druid, no?

Still? Seeing just some of the weirdness out there, I worry about an important but small detail escaping notice.

What kind of monster took Lindsey? And do I have the right to denigrate anyone who is working against him? I need to go back and leave my overly-developed ego at the door.

Happy Hanukkah

The Hanukkah Story
Published: December 10, 2009

Tonight Jewish kids will light the menorah, spin their dreidels and get their presents, but Hanukkah is the most adult of holidays. It commemorates an event in which the good guys did horrible things, the bad guys did good things and in which everybody is flummoxed by insoluble conflicts that remain with us today. It’s a holiday that accurately reflects how politics is, how history is, how life is.

It begins with the spread of Greek culture. Alexander’s Empire, and the smaller empires that succeeded it, brought modernizing ideas and institutions to the Middle East. At its best, Hellenistic culture emphasized the power of reason and the importance of individual conscience. It brought theaters, gymnasiums and debating societies to the cities. It raised living standards, especially in places like Jerusalem.

Many Jewish reformers embraced these improvements. The Greeks had one central idea: their aspirations to create an advanced universal culture. And the Jews had their own central idea: the idea of one true God. The reformers wanted to merge these two ideas.

Urbane Jews assimilated parts of Greek culture into their own, taking Greek names like Jason, exercising in the gymnasium and prospering within Greek institutions. Not all Jews assimilated. Some resisted quietly. Others fled to the hills. But Jerusalem did well. The Seleucid dynasty, which had political control over the area, was not merely tolerant; it used imperial money to help promote the diverse religions within its sphere.

In 167 B.C., however, the Seleucid king, Antiochus IV, issued a series of decrees defiling the temple, confiscating wealth and banning Jewish practice, under penalty of death. It’s unclear why he did this. Some historians believe that extremist Jewish reformers were in control and were hoping to wipe out what they saw as the primitive remnants of their faith. Others believe Antiochus thought the Jews were disloyal fifth columnists in his struggle against the Egyptians and, hence, was hoping to assimilate them into his nation.

Regardless, those who refused to eat pork were killed in an early case of pure religious martyrdom.

As Jeffrey Goldberg, who is writing a book on this period, points out, the Jews were slow to revolt. The cultural pressure on Jewish practice had been mounting; it was only when it hit an insane political level that Jewish traditionalists took up arms. When they did, the first person they killed was a fellow Jew.

In the town of Modin, a Jew who was attempting to perform a sacrifice on a new Greek altar was slaughtered by Mattathias, the old head of a priestly family. Mattathias’s five sons, led by Judah Maccabee, then led an insurgent revolt against the regime.

The Jewish civil war raised questions: Who is a Jew? Who gets to define the right level of observance? It also created a spiritual crisis. This was not a battle between tribes. It was a battle between theologies and threw up all sorts of issues about why bad things happen to faithful believers and what happens in the afterlife — issues that would reverberate in the region for centuries, to epic effect.

The Maccabees are best understood as moderate fanatics. They were not in total revolt against Greek culture. They used Greek constitutional language to explain themselves. They created a festival to commemorate their triumph (which is part of Greek, not Jewish, culture). Before long, they were electing their priests.

On the other hand, they were fighting heroically for their traditions and the survival of their faith. If they found uncircumcised Jews, they performed forced circumcisions. They had no interest in religious liberty within the Jewish community and believed religion was a collective regimen, not an individual choice.

They were not the last bunch of angry, bearded religious guys to win an insurgency campaign against a great power in the Middle East, but they may have been among the first. They retook Jerusalem in 164 B.C. and rededicated the temple. Their regime quickly became corrupt, brutal and reactionary. The concept of reform had been discredited by the Hellenizing extremists. Practice stagnated. Scholarship withered. The Maccabees became religious oppressors themselves, fatefully inviting the Romans into Jerusalem.

Generations of Sunday school teachers have turned Hanukkah into the story of unified Jewish bravery against an anti-Semitic Hellenic empire. Settlers in the West Bank tell it as a story of how the Jewish hard-core defeated the corrupt, assimilated Jewish masses. Rabbis later added the lamp miracle to give God at least a bit part in the proceedings.

But there is no erasing the complex ironies of the events, the way progress, heroism and brutality weave through all sides. The Maccabees heroically preserved the Jewish faith. But there is no honest way to tell their story as a self-congratulatory morality tale. The lesson of Hanukkah is that even the struggles that saved a people are dappled with tragic irony, complexity and unattractive choices.

As posited by Judaism 101: The Traditional Hanukkah Story

And, in a nod to another tradition, here is Adam Sandler's original Chanukah (Hanukkah) Song:

Friday, December 11, 2009

Malignancy as a Complication of CRPS

Malignancy as a Possible Complication of Complex Regional Pain Syndrome: A Case Report
© 2009 American Academy of Pain Medicine, Pain Medicine
Published Online: 9 Dec 2009

Rick Kennedy, FRCA,* Joan Hester, FRCA, MSc, FFPMRCA,* and Dominic W. N. Simon, FRCS (Tr & Orth), BSc †
*Department of Pain Relief, King's College Hospital, London; † Basingstoke and North Hampshire Hospital, Basingstoke, Hampshire, UK

Correspondence to Rick Kennedy, FRCA
Anaesthetic Department, St Thomas' Hospital
Lambeth Palace Road, London SE1 7EH, UK
Tel: 44-7986360997; Fax: 00-61893463481
Sources of support: None was received.

A synovial sarcoma presented in the knee of a young woman 20 years after the onset of pain which was attributed to complex regional pain syndrome (CRPS). Was this a chance occurrence, or could there be any link between the two conditions? Did the pain itself and the persistent inflammatory and immunological response to pain contribute to the development of malignancy, or could the malignancy have been present subclinically for many years and have contributed to the ongoing pain syndrome? This case report looks into the diagnosis of synovial sarcoma and CRPS and the relationship between the neurogenic inflammation seen in CRPS and that seen in malignancies. The diagnosis of CRPS is a diagnosis of exclusion. Constant vigilance of patients with this unpleasant condition is necessary.


Clinical Question: Is CRPS-I associated with malignancy?

Bone metastases can mimic a Complex Regional Pain Syndrome I

Rheumatic Manifestations in Malignancy

Squamous Cell Carcinoma Occurring Within Incision of Recently Implanted Spinal Cord

Complex regional pain syndrome type I in cancer patients

The Upper Room

Let Mahalia sing you into and through the Upper Room. It's a boring post; She's not!

It's a cold December morning, quite beautiful.

Retired Educator, here. Over the course of several days last week, The Manor Hazmat Team and I excavated my office, hidden in the nosebleed section of one of the more neglected wings. We reclaimed that space in the name of All That is Good and Holy in Marlinspike Hall -- deep, deep in the Tête de Hergé (Très Décédé, D'ailleurs).

Inexplicably, I decided to change the wall art from trustworthy and overseen impressionistes to a series by Miró, and thereby managed to lend a decidedly childlike air to the room. Not the look I was going for but that's okay. I can do childlike. I like childlike. On my very best days, I am childlike.

Actually, in the right light, in the proper frame of mind? Miró's work asserts itself as more ELEMENTAL than jejune, just not in the typically monumental way that I normally envision les principes de bases -- as found in Rothko, for example. Our Private and Supremely Elegant Manor Suite is done in Rothko -- nicely set off by row upon row of mirrored ceiling tile. Sure, there are moments when the blocks of color oppress and Rothko's famed depression almost bleeds out and your thoughts turn all helterskelter-like.

Ummm, right?

In the course of things, have I ever mentioned that Fred was once the recipient of an Honorary Chapter Medalist Award, given by the American Society of Interior Designers? Yes, he was! I remember the frenzy. He had to assemble several portfolios, each representative of his various and eccentric Philosophies of Design, to which he had to attach a typewritten version of his originally longhanded thesis, "In Defense of Polyester." After first creating it, he spiffed up his CV, finagled the requisite three ASID Chapter Board Member endorsements, provided a detailed bulleted list of the location and patronage of his famed trompe l'oeil wall and window treatment creations, as well as proffering proof of degrees, honors, citations, arrests, outstanding parking tickets, and so forth.

Anyway, he's an Award Winner!

What he has done in our suite of rooms is create an intricate system of wall hangings that can be kept rolled up, much like the various canvas panels for the Big Top in a circus. On those days when a heavy fog hangs over Captain Haddock's holdings, and the Rothkos, all tragic and impending, loom extra large -- we just drop the canvas leaves of our Moroccan-style tent. There are several design choices available per wall, or we can choose to disguise the structural planes with billowy fabrics in an amorous hommage to the Ottoman Harem.

For some ungodly reason, Fred has it in his head to paint a mural on one of my recently uncovered office walls. It figures, no? I cannot get the man to consult his extant and lengthy "honey do" list -- but this, he will do, right away.

Just the archaelogy involved in reaching the original wall dampens my resolve -- steaming away layers of period wallpaper, chipping, disintegrating paint, all the way down to creative combinations of wood, stone, mud, straw, peat.

"What kind of mural have you in mind?" I ask him, curious.

"Something restful, yet vibrant, something unique to you, yet universal..." I swear, I think his eyes were crossing with the effort of coming up with that bit of effluvium. In the interest of saving you time, I cut the transcription short: you know how I dislike rambling.

I finally convinced The Fredster to try a fairly muted, tonal abstract in the form of a fresco, the very idea of which may keep him occupied through the winter. Right on cue to distract My Darling Artisan, the chirping Bonne et Belle Bianca Castafiore arrived on scene wrapped in a voluminous and inexplicablly Miró-like japanese kimono (MavenMatron sized) and sporting the latest trend in Foot-Binding -- high-heeled torture devices that keep the wearer interminably en pointe:

The first task I set the Handy Man? A new, reinforced door with three foolproof locks. The Castafiore may show little interest in my recuperated space *today* -- but who knows how she may feel tomorrow, eh?

It is a good place in which to sit and write, my office, defended now by a reinforced steel door with a set of bright-nickel finished, interfaced-and-intwined redundant locks.

Look out the window at The Copse and The Rarest of Birds in Our Aviary, and you see the proof of our failed attempts at gardening and animal husbandry. Suckers and Sprouts, Suckers and Sprouts! We forgot to trim back the new growth in The Copse for a few, cough, years, and Nature has gone wild, as is Nature's Wont. The Gamekeeper's predilection is for birds of prey, as evidenced by the Gaggle of Red Kites, once hunted to extinction, now clearly in full recovery within Our Aviary's netting. I fear the advent of Red Kite Zombies, the reanimated dead with no prey but their own kind.


All the more reason to turn inward, to my warm, inviting, and elemental home office!

Shucks, I wish it were that simple, a turning away from what amounts to a huge Bio-Botanical Failure to Cooperate, in favor of the turning inward to some hoped for Trope of Instant Wisdom [Just Add Water and Stir].

But the Unfortunate Real World cannot be kept out, even from this well-planned and superbly-appointed lair (there is a club chair done in actual Corinthian Leather, fashioned from an equally actual 1976 Chrysler Cordoba).

In the course of clearing out mounds of paperwork from my last stint as a teacher, I found some items that proved very dear, and some that I would like to share. They represent, on the one hand, the unseen and unacknowledged work of teachers, and, on the other, the often unrecognized realities at work in the lives of today's teenagers, Our Belovèd Yute.

And then there are just the oddities that represent public high school education in what is euphemistically known as "the urban environment."

So stay tuned. After a nap or coma, I'm going to tackle deficiency reports and guardian contact forms in the next post.

While you're patiently waiting, please enjoy this recorded message from Ricardo Gonzalo Pedro Montalbán y Merino...

Tuesday, December 8, 2009

WORDLE SOLUTIONS and How The Computer Ate My Blog Post

Howdy High, There, Buckaroos! Retired Educator, here.

Since the 2009 Thanksgiving Wordle Challenge was such a Total Yawn, despite my best efforts at prostitution through Tweeter, I am posting the solutions below. Actually, I am doing this because of an inability to get any real writing done. Last night, I labored over a long post on ketamine, about which I was quite proud, and it went *poof*. Out, gone, aloft in the blogosphere, more of my amorphous nonsense.

I am one of those people who rolls eyes when folks lament, long and loud, how the computer "lost" or "ate" their work. They usually further insist that they *did* save it, really!

"That there computer has a mind of its own..." Right, Grandpa.

No, computers only do what we "tell" them to do.

Or so I thought.

That ketamine coma post was really good. It had none of my normal foolishness. It toed a line now obscured by a strong and unexpected imaginary sand storm that quickly reduced visibilty to nil. You know how hard sand can be on high-end electronics.

I dotted every "i" and researched every outrageous claim, underlining what I knew to be the truth at the expense of facts that I chose simply to ignore. It rivaled the work I produced while perched on top of the rooster weathervane that, itself, was planted atop the highest point of the Ivory Tower. Now, *that* was a breathtaking act of unbalanced derring-do!

In fact, when brought nearly to fruition (around 8 pm, 7 December), the ketamine coma piece could not help but bring to mind my unparralleled study of Parisian graffiti produced in the various revolutionary spaces of May 1968.

Ever since stabbing Fred with that sharp, rusty fork yesterday evening for suggesting, perkily, that I "just" get right back to work and reproduce what the 'puter clearly deliberately disposed of... Ever since then, Fred has been wimpering and tossing out the odd and clearly unrehearsed "baaaad computer, baaaaad" in between moans and the mounting double threats of sepsis and lockjaw.

It's good to see him make an effort.

So I guess we will scrape up the money to have some Urgent Care version of a longstanding family doctor [whom our people always repay in quart jars of homemade strawberry preserves and 5 or so fresh eggs] lance what is festering on and around The Fredster.

I heard -- down on the corner -- that if we offer the Urgent Care Admissions Clerk a fresh potted-meat sandwich, we can get a complimentary vasectomy. I say "we," but I really mean "Fred."

Anyway, I appreciate your faithfulness and truly do apologize for the bizarreries of late. I realize that when one's life begins to be nothing but a stringing together of missteps and the totally unforeseen, it's perhaps time to re-evaluate things.

These deep thoughts, and others, I toss into the frigid cold of this December night, and laugh.

So here's the skinny on the Wordles:

#9: "At the little town of Vevay, in Switzerland, there is a particularly comfortable hotel." These are the opening lines to Henry James' Daisy Miller.

#10: The inimitable Gabriel García Márquez and his lovely One Hundred Years of Solitude: "Amaranta Úrsula returned with the angels of December, driven on a sailor's breeze, leading her husband by a silk rope tied around his neck."

#11: "One day, perhaps, the world may taste the pickles of history." From Salman Rushdie's Midnight's Children.

#12: "Contrary to expectation, there was a touch of gaiety in the air, with total strangers willing to engage in conversation on any topic, though uppermost in everyone's mind were the scarcity of fuel and the increasingly frequent power cuts." Okay, so this one? You either knew it or you did not. I truly think the first 3 were possible to tease and reason out... Though the fact that Madame Fresca could not is perhaps ample evidence to the contrary. #12 was taken from the first chapter of Gifts by Nuruddin Farah.

There is, admittedly, a small part of me that thinks you are all Evil-Doers of the Nth Degree who simply did not desire that Fred and I should enjoy an evening alone together, and so, you played dumb and refused to win the 2009 Thanksgiving Wordle Challenge Prize of taking La Bonne et Belle Bianca Castafiore to the Dairy Queen.

That's okay. I'll get you next time.

Monday, December 7, 2009

More evidence for supraspinal mechanism in CRPS/RSD

From H. Uematsu, M. Sumitani, A. Yozu, Y. Otake, M. Shibata, T. Mashimo, and S. Miyauchi of the Department of Acute Critical Medicine (Anesthesiology) of Osaka University's Graduate School of Medicine comes this study [via PubMed]:

Complex Regional Pain Syndrome (CRPS) Impairs Visuospatial Perception, whereas Post-Herpetic Neuralgia (PHN) does not: Possible Implications for Supraspinal Mechanism of CRPS, published in the Annals of the Academy of Medicine, Singapore (2009 Nov;38(11):931-6).

Introduction -- Complex regional pain syndrome (CRPS) patients show impaired visuospatial perception in the dark, as compared to normal patients with acute nociceptive pain. The purpose of this study is 2-fold: (i) to ascertain whether this distorted visuospatial perception is related to the chronicity of pain, and (ii) to analyse visuospatial perception of CRPS in comparison with another neuropathic pain condition.
Materials and Methods -- We evaluated visual subjective body-midline (vSM) representation in 27 patients with post-herpetic neuralgia (PHN) and 22 with CRPS under light and dark conditions. A red laser dot was projected onto a screen and moved horizontally towards the sagittal plane of the objective body-midline (OM). Each participant was asked to direct the dot to a position where it crossed their vSM. The distance between the vSM and OM was analysed to determine how and in which direction the vSM deviated.
Results -- Under light condition, all vSM judgments approximately matched the OM. However, in the dark, CRPS patients, but not PHN patients, showed a shifted vSM towards the affected side.
Conclusion -- We demonstrated that chronic pain does not always impair visuospatial perception. The aetiology of PHN is limited to the peripheral nervous system, whereas the distorted visuospatial perception suggests a supraspinal aetiology of CRPS.