Painful supernumerary phantom arm following motor cortex stimulation for central poststroke pain. Case report.

In this report, the authors describe a case in which the patient began to experience a supernumerary phantom arm after she received motor cortex stimulation for central pain. The patient had a history of right thalamocapsular stroke. It is speculated that the motor cortex activation triggered a response in the patient's parietal lobe, precipitating perception of the phantom limb. To the authors' knowledge this is the first reported case of its kind.

[1]  E. Weinstein,et al.  Delusional reduplication of parts of the body. , 1954, Brain : a journal of neurology.

[2]  M. Franzen,et al.  Delusional reduplication following closed-head injury. , 1992, Brain injury.

[3]  J. Marshall,et al.  Supernumerary phantom limb after right hemispheric stroke. , 1995, Journal of neurology, neurosurgery, and psychiatry.

[4]  M. Critchley.  The parietal lobes , 1966 .

[5]  Hans Ehrenwald.  Verändertes Erleben des Körperbildes mit konsekutiver Wahnbildung bei linksseitiger Hemiplegie. , 1930 .

[6]  P. Vuilleumier,et al.  Four legs. Illusory reduplication of the lower limbs after bilateral parietal lobe damage. , 1997, Archives of neurology.

[7]  D. Benson,et al.  Phantom limb and multiple sclerosis , 1979, Neurology.

[8]  Z. Nasreddine,et al.  Pain after thalamic stroke: Right diencephalic predominance and clinical features in 180 patients , 1997, Neurology.

[9]  G. Zeilig,et al.  ‘Duplicate limbs’ sensation in acute traumatic quadriplegia , 1989, Paraplegia.

[10]  C. Koch,et al.  Are we aware of neural activity in primary visual cortex? , 1995, Nature.

[11]  J C Rothwell,et al.  Reorganization of cortical blood flow and transcranial magnetic stimulation maps in human subjects after upper limb amputation. , 1994, Journal of neurophysiology.

[12]  D. Wolpert,et al.  Maintaining internal representations: the role of the human superior parietal lobe , 1998, Nature Neuroscience.

[13]  S. Canavero,et al.  Cortical stimulation for central pain. , 1995, Journal of neurosurgery.

[14]  C. Parry.  Pain in avulsion lesions of the brachial plexus , 1980, PAIN.

[15]  J. Marshall,et al.  Three arms: a case study of supernumerary phantom limb after right hemisphere stroke. , 1993, Journal of neurology, neurosurgery, and psychiatry.

[16]  Lars Ersland,et al.  Phantom limb imaginary fingertapping causes primary motor cortex activation: an fMRI study , 1996, Neuroreport.

[17]  S. Canavero,et al.  The neurochemistry of central pain: evidence from clinical studies, hypothesis and therapeutic implications , 1998, Pain.

[18]  F. Sellal,et al.  [The man with 6 arms. An analysis of supernumerary phantom limbs after right hemisphere stroke]. , 1996, Revue neurologique.

[19]  S. Canavero.  Dynamic reverberation. A unified mechanism for central and phantom pain. , 1994, Medical hypotheses.

[20]  D. Bowsher.  Pain after thalamic stroke: Right diencephalic predominance and clinical features in 180 patients , 1998, Neurology.

[21]  P. Olin,et al.  Phantom pain, anxiety, depression, and their relation in consecutive patients with amputated limbs: case reports , 1998 .

[22]  Ross Davis.  Pain and Suffering Following Spinal Cord Injury , 1975 .