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  4. Atypical Supernumerary Phantom Limb and Phantom Limb Pain in a Patient With Spinal Cord Injury: Case Report

Atypical Supernumerary Phantom Limb and Phantom Limb Pain in a Patient With Spinal Cord Injury: Case Report

Annals of Rehabilitation Medicine, 2013 · DOI: 10.5535/arm.2013.37.6.901 · Published: December 1, 2013

Spinal Cord InjuryPain ManagementRehabilitation

Simple Explanation

This case report describes a rare instance of a patient experiencing supernumerary phantom limbs (SPL), feeling extra legs, after a complete spinal cord injury. The patient also experienced phantom limb pain associated with the SPL. The intensity of both the SPL and pain decreased with visual-tactile stimulation treatment. The patient visually identified and tapped his paralyzed limbs with a wooden stick. After 2 months of treatment, the SPL sensation was reduced to 20% of the real paralyzed legs.

Study Duration
2 months of inpatient treatment
Participants
A 43-year-old man with complete spinal cord injury
Evidence Level
Case Report

Key Findings

  • 1
    A patient with complete spinal cord injury experienced supernumerary phantom limbs (SPL) and associated phantom limb pain, a rare occurrence.
  • 2
    Visual-tactile stimulation treatment, involving visual identification and tactile stimulation of the paralyzed limbs, reduced the intensity of the SPL and associated pain.
  • 3
    The telescoping phenomenon, commonly seen in amputees, was observed in this SCI patient with SPL, suggesting overlapping neurophysiological mechanisms.

Research Summary

This case report presents a rare instance of supernumerary phantom limbs (SPL) and phantom limb pain in a patient with complete spinal cord injury (SCI). The patient experienced the sensation of an additional pair of legs after a traumatic accident. Visual-tactile stimulation treatment, where the patient visually identified and tapped their paralyzed limbs, led to a reduction in the intensity of the SPL. This suggests a potential therapeutic approach for managing SPL in SCI patients. The case highlights the complex interplay between sensory feedback, body schema, and cortical reorganization in the development of phantom limb phenomena following SCI, and the potential for visual-tactile stimulation as a treatment modality.

Practical Implications

Therapeutic Intervention

Visual-tactile stimulation may be a beneficial treatment for reducing the intensity of SPL and associated pain in SCI patients.

Understanding Neural Mechanisms

Further research is needed to elucidate the neurophysiological mechanisms underlying SPL in SCI, which could lead to more targeted therapies.

Differential Diagnosis

Clinicians should be aware of the possibility of SPL in SCI patients, especially those with complete injuries, to provide appropriate management and support.

Study Limitations

  • 1
    Single case report limits generalizability.
  • 2
    Subjective nature of phantom limb sensations.
  • 3
    Lack of advanced neuroimaging studies at follow-up due to patient refusal.

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