Phantom limb sensations in the ear of a patient with a brachial plexus lesion

We report on a patient with brachial plexus avulsion who underwent sensory testing and was asked to report the location of the stimulated site and any other sensations experienced

Mariella Pazzaglia

2018

Scholarcy highlights

  • With the phantom limb phenomenon, one experiences the vivid sensation that a missing limb is still attached to the body and is moving appropriately with other body parts
  • The referral of phantom sensations elicited by the stimulation of body sites adjacent to the affected limb is reported in 60–95% of individuals with amputated limbs, but the phenomenon is frequently reported in cases of an intact limb with a loss of sensory and motor innervation due to nerve avulsion, spinal cord injury, or brachial plexus lesions
  • The amplitude of somatosensory evoked potentials indicated that signals following stimulation of this portion of ear reach both areas of the somatosensory cortex
  • Our results suggest that referred sensations following brachial plexus injury can evoke the conscious representation of a specific body part in the somatosensory cortex, and that this correspondence remains fixed throughout one’s life, independently of changes in the sensory or motor periphery and irrespectively of neuroplasticity effects
  • Stimulation of the auricular branch of the vagus nerve paired with rehabilitative training improves the perception limb by boosting neuroplasticity
  • This opens the possibility of therapies designed to preserve or restore precise cortical topography— even when sensations are transferred to a different cortical territory—preserving body representation, and potentially restoring sensorimotor function
  • Referred sensory effects could serve as a viable intervention in reducing the perception of pain or in restoring mental representation of one’s own body and the sense of bodily self following deafferentation

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