Table 1.
Summary of supernumerary phantom limb cases and characteristics after a traumatic spinal cord injury.
| Case | Age, gender, SCI classification | Onset after SCI | Description | Orientation | Timing | Positional changes | Painful | Associated sensations | Telescoped with recovery | Interventions | Outcomes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Case 1 [9] | NR, NR, C5 complete tetraplegia | NR | Two legs | NR | NR | NR | NR | NR | NR | Lower extremity ROM | Improvement with ROM |
| Case 2 [12] | 64 y, M, C5 incomplete tetraplegia | NR |
Two hands Two legs |
Parallel to actual limbs or crossed over chest | Intermittent | NR | No | Chest discomfort when SPL crossed over chest | NR | NR | SPL continued to intermittently occur, 1 y post injury |
| Case 3 [6] | 71 y, M, C3 AIS C | 7 d | Two arms, origin at shoulders | Extended laterally to actual limbs or crossed over chest | Intermittent, more pronounced in the afternoon and evening | More pronounced when supine, improved when sitting | No | Chest discomfort when SPL crossed over chest | Yes |
Pregabalin Rubber hand paradigm to track improvement |
No improvement with pregabalin on SPL sensations. SPL progressively improved and resolved 8 months post injury |
| Case 4 [8] | 43 y, M, C6 AIS A | 6 d | Two legs, origin at hips | Extended medially to actual limbs | Constant, more pronounced in afternoon and evening | More pronounced when supine, improved when sitting | Yes | NR | Yes |
Pregabalin, gabapentin, baclofen, tramadol, and duloxetine VTFT |
Medications and VTFT improved SPL pain. VTFT improved SPL sensations. SPL improved, but present at 13 months post injury |
| Case 5 [10] | 22 y, M, C2 AIS A | 2 y | Two arms, origin at shoulders | Right SPL flexed and left SPL extended at the shoulder | NR | More pronounced when sitting and standing, improved when supine | Yes | NR | NR | VVFT | Improvement in SPL pain after VVFT completion at 12 weeks |
| Case 6 [11] | 46 y, M, C4 AIS B | 7 d | Two hands, origin at wrist | Placed across abdomen | Constant | NR | No | Neuropathic pain in real limbs | NR |
Pregabalin, celecoxib VFT and rTMS |
No improvement with medications on SPL sensations but improvement in neuropathic pain of actual limbs. Improvement with VFT and rTMS on SPL, resolving at 127 d post injury |
| Case 7, current | 43 y, M, C4 AIS C | 6 d | Two arms, origin at shoulders | Extended medially to actual limbs or crossed over chest | Intermittent, more pronounced in the morning | More pronounced when supine, improved with sitting | No |
Neuropathic pain in real limbs, Chest discomfort when SPL crossed over chest |
No |
Pregabalin VFT and VTFT |
No improvement with pregabalin on SPL sensations but improvement in neuropathic pain of actual limbs. Improved SPL sensation with VFT and VTFT. SPL resolved by 45 d post injury |
NR not reported, y years, d days, M male, SCI spinal cord injury, AIS ASIA Impairment Scale, SPL supernumerary phantom limb, ROM range of motion, VVFT visual video feedback therapy, rTMS repetitive transcranial magnetic stimulation, VFT visual feedback therapy, VTFT visual–tactile feedback therapy.