title: Mirror therapy for phantom limb pain  in an adolescent cancer survivor.
abstract: OBJECTIVE
  Several pediatric tumors require mutilating procedures in order to be treated effectively. Although the pain caused by the surgery is usually of a transient nature, the perception of pain in the amputated limb may persist. This prolonged pain, which is often refractory to pain-killing medication, may severely affect the patient's quality of life. The phenomenon of phantom limb pain (or phantom limb syndrome) has been investigated using neurological, neurophysiological and psychopathological approaches. Here we discuss the advantages of an unconventional rehabilitation technique, the recently reported mirror therapy, whose positive effects might be due, according to some researchers, to neuronal plasticity mechanisms.
  
  
  METHODS
  We describe the use of mirror therapy to treat phantom limb syndrome in a 39-year-old patient whose right leg had been amputated at the age of 17 because of an osteosarcoma. The patient suffered from frequent episodes of pain, with severely negative effects on his quality of life.
  
  
  RESULTS
  We obtained positive subjective feedback from the patient, who reported having benefited significantly from using the mirror. The beneficial effect was still present six months after the start of mirror therapy.
  
  
  CONCLUSIONS
  The reported case highlights the value of an integrated multidisciplinary approach including neurological/physiatric assessment, clinical psychological support, physiotherapy and other, unconventional treatment modalities. This report should guide future studies towards the application of mirror therapy in order to elucidate its effects and efficacy.
authors.affiliation: Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. carlo.clerici@unimi.it
authors.forename: Carlo Alfredo
authors.initials: CA
authors.lastname: Clerici
authors.forename: Filippo
authors.initials: F
authors.lastname: Spreafico
authors.forename: Gaia
authors.initials: G
authors.lastname: Cavallotti
authors.forename: Annalisa
authors.initials: A
authors.lastname: Consoli
authors.forename: Laura
authors.initials: L
authors.lastname: Veneroni
authors.forename: Alessio
authors.initials: A
authors.lastname: Sala
authors.forename: Maura
authors.initials: M
authors.lastname: Massimino
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical / Q000523:psychology* / Q000534:rehabilitation; D000674:Amputees / Q000523:psychology / Q000534:rehabilitation*; D001642:Bicycling / Q000523:psychology; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D006794:Household Articles; D006801:Humans; D033183:Interdisciplinary Communication; D008159:Lumbar Vertebrae; D008175:Lung Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D012516:Osteosarcoma / Q000556:secondary / Q000601:surgery*; D010147:Pain Measurement; D010591:Phantom Limb / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D026741:Physical Therapy Modalities / Q000295:instrumentation / Q000523:psychology; D011788:Quality of Life; D012008:Recurrence; D013125:Spinal Neoplasms / Q000556:secondary / Q000601:surgery