PHANTOM ARM AND LEG AFTER PONTINE HEMORRHAGE

Abstract

The phantom limb appears not only after limb amputation1 but also after brain damage (known as supernumerary phantom limb [SPL]).2 A previous review1 on phantom limb following limb amputation proposed the remapping hypothesis of topographic reorganization of somatosensory cortex in which the referred sensation from the neighboring receptive field to phantoms is one of at least five possible sources for phantom sensation. On the other hand, the current theories of SPL emphasize the dissociation between established sensorimotor limb representation and marked changes in afferent and efferent signals in brain–limb communication.3,4 There is little information about SPL in patients with brainstem damage,5 which has somewhat different characteristics from phantom sensations following supratentorial cerebral lesions, as well as from phantoms following limb amputation. Here we address the contribution of the brainstem to SPL. ### Case reports. A 47-year-old woman (Case 1) and a 55-year-old man (Case 2) developed acute pontine hemorrhage (figure, A [a, b] and B [a, b]). They survived a locked-in period with complete paralysis except for vertical eye movements. The neurologic examination …