Phantom limb after stroke: An underreported phenomenon

Daniel Antoniello, Benzi M. Kluger, Daniel H. Sahlein, Kenneth M. Heilman

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

The presence of a phantom limb (PL) resulting from a cerebral lesion has been reported to be a rare event. No prior study, however, has systematically investigated the prevalence of this syndrome in a group of post-stroke individuals. Fifty post-stroke individuals were examined with structured interview/questionnaire to establish the presence and perceptual characteristics of PLs. We document the presence of phantom experiences in over half of these individuals (n= 27). We provide details of these phantom experiences and further characterize these symptoms in terms of temporal qualities, posture, kinesthesia, and associated features. Twenty-two participants reported postural phantoms, which were perceived as illusions of limb position that commonly manifested while lying in bed at night - a time when visual input is removed from multi-sensory integration. Fourteen participants reported kinesthetic phantoms, with illusory movements ranging from simple single joint sensations to complex goal-directed phantom movements. A striking syndrome of near total volitional control of phantom movements was reported in four participants who had immobile plegic hands. Reduplicative phantom percepts were reported by only one participant. Similarly, phantom pain was present in only one individual - the sole participant with a pre-stroke limb amputation. The results suggest that stroke results in phantom experiences more commonly than previously described in the literature. We speculate that subtotal deafferance or defective motor efference after stroke may manifest intermittently as a PL.

Original languageEnglish (US)
Pages (from-to)1114-1122
Number of pages9
JournalCortex
Volume46
Issue number9
DOIs
StatePublished - Oct 1 2010

Keywords

  • Anosognosia
  • Body schema
  • Phantom limb
  • Post-stroke recovery
  • Sensorimotor illusions

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Experimental and Cognitive Psychology
  • Cognitive Neuroscience

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    Antoniello, D., Kluger, B. M., Sahlein, D. H., & Heilman, K. M. (2010). Phantom limb after stroke: An underreported phenomenon. Cortex, 46(9), 1114-1122. https://doi.org/10.1016/j.cortex.2009.10.003