Supernumerary phantom limb in a patient with basal ganglia hemorrhage - a case report and review of the literature

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Issue Date
BioMed Central
BMC Neurology, 17(1):180
Supernumerary phantom limbBasal ganglia hemorrhageIntentional movement
AIDP: Acute inflammatory demyelinating polyradiculoneuropathy; BG: Basal ganglia; CI: Cerebral infarction; Dx: Diagnosis; FL: Frontal lobe; ICH: Intracerebral hemorrhage; Lt: Left; MCA: Middle cerebral artery; NS: Neurosarcoidosis; PN: Peripheral nerve; PTE: Post-traumatic epilepsy; Rt: Right; SAH: Subarachnoid hemorrhage; SC: Spinal cord; SjS: Sjogrens syndrome; SPL: Supernumerary phantom limb; Sz: Seizure; TBI: Traumatic brain injury; TL: Temporal lobe; TM: Traumatic myelopathy; TPC: Temporoparietal lobe

Supernumerary phantom limb (SPL) is a rare neurologic phenomenon, in which a patient misperceives an extra limb in addition to the original set of limbs. We report a case of SPL in a patient with a right basal ganglia hemorrhage and review the previous literature about this peculiar phenomenon.

Case presentation
Two days after the event of a right basal ganglia hemorrhage, a 78-year-old male reported a phantom arm protruding from his left shoulder. He could not see or touch the phantom arm but he felt the presence of an addition arm lateral to his paretic arm. Pain or sensory discomfort were absent in either the paretic arm or the phantom arm. He stated that he could intentionally move the phantom arm independent of his paretic arm. The examination showed that the passive movement of his paretic arm did not elicit any movement of his phantom arm. We diagnosed the SPL as a complication of the hypertensive basal ganglia hemorrhage and treated him with anti-hypertensive medications. His phantom arm persisted for 3 weeks, and it gradually faded away.

SPL had been reported as a rare complication of various types of cerebral lesions. Right hemispheric lesions were most frequently associated with the SPL. Considering the intentional movement of the phantom arm, we deduced that the SPL might result from the impairment of the sensory feedback system for both internal body image and motor movement.
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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