Abstract
Neurophysiologic adaptations after amputation predispose amputees to sympathetic hyperactivity. Anxiety is linked to increased catecholamine levels, which may exacerbate sympathetic activation of nociceptors. Sustained sympathetic discharge can further reduce efferent sympathetic action potential thresholds. This cyclic facilitation would expectedly result in increased signs of sympathetic hyperactivity over time, including hypoesthesia, epidermis color change, epidermis temperature change, edema, skin breakdown, allodynia, hyperalgesia, and contracture.
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