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Published 2 February 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.09.2008.0851]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Disappearance of "phantom limb" and amputated arm usage during dreaming in REM sleep behaviour disorder

Roberto Vetrugno1, Isabelle Arnulf2, Pasquale Montagna1

1 University of Bologna, Dpt. of Neurological Sciences, Via Ugo Foscolo 7, Bologna, 40123, Italy
2 Federation des Pathologies du Sommeil, Hopital Pitié-Salpetriere, Assistance Publique Hopitaux de Paris, Paris, France

Correspondence to:
roberto.vetrugno{at}unibo.it

SUMMARY

Limb amputation is followed, in approximately 90% of patients, by "phantom limb" sensations during wakefulness. When amputated patients dream, however, the phantom limb may be present all the time, part of the time, intermittently or not at all. Such dreaming experiences in amputees have usually been obtained only retrospectively in the morning and, moreover, dreaming is normally associated with muscular atonia so the motor counterpart of the phantom limb experience cannot be observed directly. REM sleep behaviour disorder (RBD), in which muscle atonia is absent during REM sleep and patients act out their dreams, allows a more direct analysis of the "phantom limb" phenomena and their modifications during sleep.


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