Ann Rehabil Med.  2015 Aug;39(4):630-633. 10.5535/arm.2015.39.4.630.

Successful Treatment of Phantom Limb Pain by 1 Hz Repetitive Transcranial Magnetic Stimulation Over Affected Supplementary Motor Complex: A Case Report

• Lee JH
• Byun JH
• Choe YR
• Lim SK
• Lee KY
• Choi IS

• KMID: 2148235
• DOI: http://doi.org/10.5535/arm.2015.39.4.630

Abstract

A 37-year-old man with a right transfemoral amputation suffered from severe phantom limb pain (PLP). After targeting the affected supplementary motor complex (SMC) or primary motor cortex (PMC) using a neuro-navigation system with 800 stimuli of 1 Hz repetitive transcranial magnetic stimulation (rTMS) at 85% of resting motor threshold, the 1 Hz rTMS over SMC dramatically reduced his visual analog scale (VAS) of PLP from 7 to 0. However, the 1 Hz rTMS over PMC failed to reduce pain. To our knowledge, this is the first case report of a successfully treated severe PLP with a low frequency rTMS over SMC in affected hemisphere.

Keyword

Phantom limb pain; Motor cortex; Repetitive transcranial magnetic stimulation

MeSH Terms

Adult
Amputation
Humans
Motor Cortex
Phantom Limb*
Transcranial Magnetic Stimulation*
Visual Analog Scale

Figure

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  Fig. 1 Neuro-navigation system indicating primary motor cortex (white arrow) and supplementary motor complex (black arrow).

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  Fig. 2 Visual analog scale (VAS) of phantom limb pain reduced by the 3rd to the 6th rounds of treatment on supplementary motor complex.

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  Fig. 3 Visual analog scale (VAS) of residual limb pain reduced by the 3rd to the 6th rounds of treatment on supplementary motor complex.

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