Phantom Limb Sensations after Mine-Blast Injury: A Clinical Case Report

RELEVANCE. Mine-blast injury is one of the most severe types of combat-related injury, frequently leading to limb amputations and the development of postamputation pain. Traditionally, research and clinical practice have primarily focused on the phenomenon of phantom limb pain. However, an equally important manifestation among phantom sensory phenomena is phantom limb sensations - non-painful experiences that include the feeling of the presence of the lost limb, its movement, temperature changes, and paresthesias. Although phantom limb sensations are not accompanied by pronounced nociceptive qualities, they have a significant impact on patients’ quality of life, complicate prosthetic rehabilitation, and may precede the onset of phantom limb pain. AIM. To present a clinical case of a patient with isolated phantom limb sensations after amputation due to high-energy mine-blast injury, and to discuss the pathogenetic mechanisms of this condition along with current therapeutic approaches. MATERIALS AND METHODS. Based on the analysis of medical records, we provide a clinical description of the disease course in a patient who sustained a mine-blast injury with subsequent above-knee amputation. The report includes medical history, timing of hospitalization, complaints, results of laboratory and instrumental examinations, details of therapy administered, and clinical dynamics. RESULTS. The patient experienced phantom limb sensations described as a feeling of a “cold shin” in the absent limb. Phantom limb pain was not reported. Despite comprehensive pharmacotherapy (anticonvulsants, antidepressants at medium therapeutic doses), physiotherapy, and psychotherapeutic support, the phantom limb sensations persisted, demonstrating their resistance to standard approaches. CONCLUSION. This clinical case highlights the need to distinguish phantom limb sensations as a separate subtype of phantom sensory phenomena. Their diagnosis and treatment require a multidisciplinary approach, including pharmacological management, psychotherapy, and modern rehabilitation strategies. Phantom limb sensations should be regarded as a clinically significant factor affecting rehabilitation and prosthetic adaptation, as well as a potential predictor of phantom limb pain.