title: Supernumerary phantom limbs in spinal cord injury.
abstract: OBJECTIVE
  Case report and review of supernumerary phantom limbs in patients suffering from spinal cord injury (SCI).
  
  
  METHODS
  SCI rehabilitation centre.
  
  
  METHODS
  After a ski accident, a 71-year-old man suffered an incomplete SCI (level C3; AIS C, central cord syndrome), with a C3/C4 dislocation fracture. From the first week after injury, he experienced a phantom duplication of both upper limbs that lasted for 7 months. The supernumerary limbs were only occasionally related to painful sensation, specifically when they were perceived as crossed on his trunk. Although the painful sensations were responsive to pain medication, the presence of the illusory limb sensations were persistent. During neurological recovery, the supernumerary limbs gradually disappeared. A rubber hand illusion paradigm was used twice during recovery to monitor the patient's ability to integrate visual, tactile and proprioceptive stimuli.
  
  
  CONCLUSIONS
  Overall, the clinical relevance of supernumerary phantom limbs is not clear, specific treatment protocols have not yet been developed, and the underlying neural mechanisms are not fully understood. Supernumerary phantom limbs have been previously reported in patients with (sub)cortical lesions, but might be rather undocumented in patients suffering from traumatic SCI. For the appropriate diagnosis and treatment after SCI, supernumerary phantoms should be distinguished from other phantom sensations and pain syndromes after SCI.
authors.affiliation: Spinal Cord Injury Centre, University Hospital Balgrist, University of Zürich, Zurich, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Curt
authors.forename: C Ngo
authors.initials: CN
authors.lastname: Yengue
authors.forename: L M
authors.initials: LM
authors.lastname: Hilti
authors.forename: P
authors.initials: P
authors.lastname: Brugger
mesh_terms: D000368:Aged; D020210:Central Cord Syndrome / Q000150:complications / Q000175:diagnosis* / Q000534:rehabilitation; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010591:Phantom Limb / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation; D026741:Physical Therapy Modalities / Q000295:instrumentation; D011782:Quadriplegia / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation; D011859:Radiography