Effects of combined rTMS and visual feedback on the rehabilitation of supernumerary phantom limbs in a patient with spinal cord injury:A case report  

作　　者：Yin-Shan Lu Pei Tong Tie-Cheng Guo Xin-Hua Ding Song Zhang Xiu-Juan Zhang 

机构地区：[1]Department of Rehabilitation Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei Province,China [2]Department of Rehabilitation Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei Province,China [3]Department of Rehabilitation Medicine,Taikang Tongji(Wuhan)Hospital,Wuhan 430000,Hubei Province,China [4]Department of Rehabilitation Medicine,Chengdu Second People's Hospital,Chengdu 610011,Sichuan Province,China

出　　处：《World Journal of Clinical Cases》2019年第19期3120-3125,共6页世界临床病例杂志

摘　　要：BACKGROUND Supernumerary phantom limb(SPL)caused by spinal cord injury(SCI)has previously been reported in several studies.However,the mechanisms and management of SPL in SCI patients are still not fully understood.Herein,we report a rare case of SPL in a patient with incomplete SCI.CASE SUMMARY A 46-year-old man complained of four hands 7 d after SCI.He was diagnosed with SPL complicated with actual limb neuropathic pain.Following a period of treatment with neurotrophic agents and Chinese traditional and analgesic medications,SPL symptoms and actual limb pain did not improve.However,his symptoms gradually lessened after combined treatment with high-frequency repetitive transcranial magnetic stimulation(rTMS),a promising neuromodulation technique,over the M1 cortex and visual feedback.After 7 wk of this treatment,SPL disappeared completely and actual limb pain was significantly relieved.CONCLUSION Cerebral plasticity changes may be a mechanism underlying the occurrence of non-painful SPL in SCI patients,and high-frequency rTMS applied to the M1 cortex could be a promising treatment method for SPL.BACKGROUND Supernumerary phantom limb(SPL) caused by spinal cord injury(SCI) has previously been reported in several studies. However, the mechanisms and management of SPL in SCI patients are still not fully understood. Herein, we report a rare case of SPL in a patient with incomplete SCI.CASE SUMMARY A 46-year-old man complained of four hands 7 d after SCI. He was diagnosed with SPL complicated with actual limb neuropathic pain. Following a period of treatment with neurotrophic agents and Chinese traditional and analgesic medications, SPL symptoms and actual limb pain did not improve. However, his symptoms gradually lessened after combined treatment with high-frequency repetitive transcranial magnetic stimulation(rTMS), a promising neuromodulation technique, over the M1 cortex and visual feedback. After 7 wk of this treatment, SPL disappeared completely and actual limb pain was significantly relieved.CONCLUSION Cerebral plasticity changes may be a mechanism underlying the occurrence of non-painful SPL in SCI patients, and high-frequency rTMS applied to the M1 cortex could be a promising treatment method for SPL.

关 键 词：SUPERNUMERARY phantom LIMB Spinal CORD injury REPETITIVE TRANSCRANIAL magnetic stimulation Visual feedback Case report 

分 类 号：R74[医药卫生—神经病学与精神病学]