Alien hand syndrome is a neurological disorder in which the afflicted persons hand appears to take on a mind of its own. Alien hand syndrome is best documented in cases where a person has had the two hemispheres of their brain surgically separated, a procedure sometimes used to relieve the symptoms of extreme cases of epilepsy and epileptic psychosis, e. The curious case of alien hand syndrome today i found out. Strangelove syndrome is a category of conditions in which a person experiences their limbs acting seemingly on their own, without conscious control over the actions. Alien hand syndrome is a rare neurological disorder in which one hand functions involuntarily, with the victim completely unaware of its action. Two patients had automatonlike movements of their left hands and arms alien hand syndrome following damage to the brain. Bizarre as this fictional character is, a similar movement disorder can occur in neurologic disease. Case report buyukgol h1, gunes m2 and eren fa2 1kto karatay university medicana faculty of medicine, department of neurology, konya, turkey 2aksaray training and research hospital, department of neurology, aksaray,turkey. It also occurs in some cases after brain surgery, stroke, infection, tumor. While the example above may be extreme, people who suffer from ahs have exhibited similar symptoms in certain cases.
Nov 19, 2005 one particularly unorthodox subtype of alien hand syndrome can arise due to lesions on the corpus callosum, producing a phenomenon called intermanual conflict. A case report and approach to rehabilitation find, read. The alien hand syndrome is a striking phenomenon characterized by purposeful and autonomous movements that are not voluntarily initiated. Alien hand syndrome an overview sciencedirect topics. Jan 20, 2011 she has suffered from alien hand syndrome for 18 years, but fortunately for karen her doctors have now found a medication that seems to have brought the right side of her brain back under some. Alien hand syndrome ahs is an extremely rare disorder. Alien hands can perform complex acts such as undoing butt. An 81 year old right handed woman developed a left alien hand syndrome characterised by involuntary movements of choking and hitting the face, neck, and shoulder. This is an interesting report of a case of alien hand syndrome.
This syndrome characteristically arises after brain trauma, brain surgery, stroke or encephalitis. Alien hand syndrome ahs is a rare condition that occurs in patients with brain injury. Furthermore, signs and symptoms of alien hand syndrome may vary on an individual basis for each patient. Jul 01, 2016 this is an interesting report of a case of alien hand syndrome. For most people, a hand which behaves in anyway which is not deliberate or conscious, is already erratic. Two major criteria for the diagnosis are complaint of a foreign limb and complex, autonomous, involuntary motor activity that is not part of an identifiable movement disorder. Patients with ahs experience one of their limbs as alien, which acts autonomously and performs meaningful movements without being guided by the intention of the patient. Intermittent alien hand syndrome caused by marchiafavabigna.
As i sat up, the affected hand rose up and hit me in the face, i couldnt control the hand, couldnt feel it. It produces complex, goaldirected motion of one hand that is involuntarily instigated. This neurological disorder is now known to be the result of specific kinds of brain damage. In the ahs literature, case studies are therefore nearly universal. Jun 04, 2014 they are believing it possessed by some intelligent or alien spirit. Because in a study, valproic acid has been shown to be beneficial in the case of migraineinduced aiws 4. I woke from sleep and i was laying on my arm, cutting off circulation. In this disorder, a patients left hand retains at least rudimentary motor and sensory functions, but the patient cannot control its movements or appreciate its sensations. The medical and neuropsychological data of an elderly female who suffered a left middle. An 81 year old right handed woman developed a left alien hand syndrome characterised by involuntary movements of choking and hitting the face, neck, and. It is clearly written and provides background on the history and classification of alien hand variants. Pdf on jan 1, 2014, david mackarel and others published alien hand syndrome. The present study shows that, in one patient with right alien hand syndrome, the use of a mirror box.
Autopsy findings in one patient demonstrated gunshot wound damage to the medial frontal white matter bilaterally, as well as the corpus callosum, right basal ganglia, internal capsule, and thalamus. Alien hand syndrome is defined as unwilled, uncontrollable, but seemingly purposeful movements of an upper limb. Numerous medical and surgical conditions can cause ahs, such as cerebral infarction, cerebral hemorrhage, corticobasal. A case report and approach to rehabilitation find, read and cite all the research you need on researchgate. We hypothesized that voluntary motor control in this condition could improve by restoring the congruency between motor intentions and visual feedback. Furthermore, the limb may interfere with the actions of their normal limb. Alfaro a, bernabeu a, badesa fj, garcia n and fernandez e 2017 when playing is a problem. Alien hand syndrome ahs is a rare and illdefined neurological disorder. The term alien hand refers to a variety of clinical conditions whose common characteristic is the uncontrolled behavior or the feeling of strangeness of one extremity, most commonly the left hand.
Alien hand syndrome sees woman attacked by her own hand bbc. Real life cases causes table of contents ahs syndrome has become evident in rare cases after some trauma to the brain or following a stroke or brain infection it is has been believed that it results from damage to the corpus callosum of the brain. The alien hand syndrome is a deeply puzzling phenomenon in which braindamaged patients experience their limb performing seemingly purposeful acts without their intention. There are a variety of clinical conditions that fall under this category, which most commonly affects the left hand. It most commonly affects the hand, but can occur in the leg. Frontiers a case of right alien hand syndrome coexisting. The signs she presented were mainly related to the frontal form of alien hand syndrome dominant hand was. This study aimed to examine neural correlates of this rare neurological disorder in a patient with corticobasal degeneration and. A compulsively readable collection, alien hand syndrome brings together over 90 fantasticbuttrue stories. Alien hand syndrome is a term used to describe a variety of rare conditions in which uncontrolled behavior or feelings of strangeness are felt in one extremity, most commonly the left hand. Affected hand is viewed as wayward and sometimes disobedient and generally out of the realm of their own voluntary control, while the unaffected hand is under normal volitional control. Alien hand syndrome is best documented in cases where a person has had the two hemispheres of their brain surgically separated, a procedure sometimes used to relieve the symptoms of extreme cases of epilepsy. In order to summarize all the presenting symptoms of alien hand syndrome, here are the following complaints of the affected.
The majority of recorded cases are a side effect of a brain operation called a corpus callosotomy. We report a case of ahs caused by malkia favabignami disease mbd. Initial descriptions were attributed to stroke and neurosurgical operations. The present study reported a case of ahs callosal subtype, in the right hand caused by callosal infarction. There are 5 classifications of alien hand syndrome ahs6 as summarized in table 1. Alien hand syndrome following corpus callosum infarction. The patient showed multiple disorders of primary sensation, sensory processing, hemispatial attention, and visual association, as well as a combination of sensory, optic, and cerebellar ataxia triple ataxia of the left arm in the. Disruption of motor control in the alien hand syndrome might result from a dissociation between intentions and sensory information.
Its unique onset and diverse clinical manifestations not only help to improve the. Alien limb syndrome is a rare presentation of cbd, callosal tumours and frontal strokes. Clinical features are consistent with cortical and subcortical involvement. It is so rare, there appears to be no available prevalence studies. A case of right alien hand syndrome coexisting with. Pdf an 81 year old right handed woman developed a left alien hand syndrome characterised by involuntary movements of choking and hitting the face. A tradesmans journey back from a cerebral incident. Pdf controlling the alien hand through the mirror box. Alien hand syndrome symptoms, causes, treatment, facts. For me, as a person with alien hand syndrome, the barriers between erratic and well, rational, are a little different. The complex phenomenon associated with this disorder falls under the rubric of alien hand syndrome. For these frustrated few, the alien hand constantly meddles in the affairs of the obedient hand. Here, we report a case of a 74years old lady diagnosed with an.
Posterior alien hand syndrome after a right thalamic infarct. The afflicted person may sometimes reach for objects and manipulate them without wanting to do so, even to the point of having to use the healthy hand to restrain the alien hand. Although the clinical entity of the alien hand syndrome was reified in the 1970s, earlier clinical descriptions are found in writings on apraxia and abnormalities of motor control. Alien hand syndrome ahs or alien limb sign includes failure to recognize ownership of ones limb when visual cues are removed, a feeling that one body part is foreign, personification of the affected body part, or autonomous activity which is perceived as outside voluntary control. The sufferers of alien hand feel that they have no control over the movements of the alien hand, but that, instead, the hand has the capability of acting independent of their conscious voluntary control. We report a case of alien hand syndrome following a left medial frontal and corpus callosum ischemic lesion. Apply knowledge of cardiovascular and brain anatomy to a clinical study of a stroke patient. Demonstrate understanding of how ischemic damage to the brain can affect speech, sensory and motor control of body movements, and on rare occasions lead to alien hand syndrome. Feb 17, 2015 alien hand syndrome is a neurological disorder in which the afflicted persons hand appears to take on a mind of its own. The person affected believes that their hand has its own free will and is usually referred as an alien behavior. The terms alienhand sign and alienhand syndrome describe phenomena experienced by patients in which an upper limb performs complex motor activities outside of volitional control. Liepmann, 12, in his seminal article on apraxia from the early 20th century, described a civil servant who among other impairments had an alien hand. Neuroradiological imaging may be inconclusive as was in our case.
These involuntary movements are unusual during or after acute stroke. Infarction of the left corpus callosum was confirmed with magnetic resonance imaging. Alien hand syndrome ahs is characterized by involuntary and autonomous activity of the affected limbs, and consists of the frontal, callosal and posterior ahs variants. The anterior frontal, callosal and posterior variants are recognized, with distinguishing clinical features and anatomical lesions. Alien hand syndrome sees woman attacked by her own hand. Aug 27, 2012 alien hand syndrome is defined as unwilled, uncontrollable, but seemingly purposeful movements of an upper limb. It has also been described in stroke subjects, after callosotomy, and in corticobasal degeneration. Here, we report a case of a 74years old lady diagnosed with an atypical parkinson syndrome by possible corticobasal degeneration. In addition, magnetic resonance angiography and digital subtraction angiography examinations revealed multiple lesions in the feeding arteries.
May 23, 20 i had alien hand syndrome, once, sort of. Clinical manifestations alien hand syndrome is an intermittent involuntary movement disorder. Normal is when my hand does something commonsense, without consciousness or control, but within context. The alien hand syndrome ahs is a fascinating movement disorder. Considering the wide variety of acquired disorders of voluntary movement, what constitutes or does not constitute alien hand seems to have been arbitrarily decided. Jun 17, 2016 alien hand syndrome ahs is a rare disorder of involuntary limb movement together with a sense of loss of limb ownership.
However, i just ran into a study that showed essentially no effect from being born without a corpus callosum the pattern of anatomical features of the brain revealed by magnetic resonance. The callosal subtype, resulting from damage to the corpus callosum, frequently features intermanual conflict. The alien hand syndrome, as originally defined, should be reserved for cases in which the hand feels foreign together with observable involuntary motor activity. A remarkable form of hemiinattention occurs in the alienhand syndrome.
It has also been described in stroke subjects, after callosotomy, and in. The impression that i got from looking at a couple of articles on alien hand syndrome was that it was an extremely common or basically guaranteed result of getting a callosotomy to treat severe epilepsy. This syndrome is characterized by a limb that seems to perform meaningful acts without being guided by the intention of the patient. Acommon classification distinguishes between the posterior or sensory form of the alien hand, and the anterior or motor form of this condition. An atypical case of alien hand syndrome in a professional pianist. The categories of frontal and callosal subtypes and their relation to behavior and neuropathology are evaluated with reference to the dual premotor system theory. There are many similar terms for the various forms of the condition, but they. The present study shows that, in one patient with right alien hand syndrome, the use of a mirror box paradigm. A case study alien hand syndrome is a term used to describe a variety of rare conditions in which uncontrolled behavior or feelings of. Alien hand syndrome ahs is a rare clinical syndrome. Alien hand syndrome in stroke archives of physical medicine. Alien hand syndrome is a rare neurological disorder that causes hand movement without the person being aware of what is happening or having control over the action.
The term alien hand is used to describe the distinctive clinical syndrome in which an upper limb performs autonomous complex movements against the patients will. A 94yearold patient developed the alien hand syndrome in the left nondominant hand following an ischemic stroke of the right parietotemporal lobe including postcentral gyrus, superior and inferior parietal lobule due to an occlusion of the posterior division of the right middle cerebral artery. Etiology usually involves infarct of the right anterior or posterior cerebral arteries or corticalbasal degeneration. The most common, or at least most well documented, cases of alien hand syndrome involve epileptics who have voluntarily undergone a procedure to separate the left and right hemispheres of the brain in an effort to control their seizures. The patient must be aware of the disturbance at least some of the time to indicate. Dec 26, 2006 alien hand syndrome ahs or alien limb sign includes failure to recognize ownership of ones limb when visual cues are removed, a feeling that one body part is foreign, personification of the affected body part, or autonomous activity which is perceived as outside voluntary control. This study aimed to examine neural correlates of this rare neurological disorder in a patient with corticobasal degeneration and alien hand syndrome of the left hand.
Hakan ay, ferdinando s buonanno, bruce h price, dean a le, walter j koroshetz. Alien hand syndrome is best document slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Mar 14, 2016 the alien hand syndrome ahs is a fascinating movement disorder. The authors provide a detailed clinical description of this syndrome caused by a vascular insult, as well as discuss diagnostic studies, treatment and outcome of this case. Posterior alien hand syndrome after a right thalamic. The most characteristic symptom, however, is limb apraxia video 40, apraxia, and the involved extremity can become so dysfunctional that it moves completely by itself and can be considered an alien limb video 39, alien hand syndrome. Sep 11, 2018 a 94yearold patient developed the alien hand syndrome in the left nondominant hand following an ischemic stroke of the right parietotemporal lobe including postcentral gyrus, superior and inferior parietal lobule due to an occlusion of the posterior division of the right middle cerebral artery. Alien hand syndrome ahs is a syndrome where patients with brain injury report involuntary movement, especially of their upper limbs.
This signs and symptoms information for alien hand syndrome has been gathered from various sources, may not be fully accurate, and may not be the full list of alien hand syndrome signs or alien hand syndrome symptoms. Alien hand syndrome history of medicine jama neurology. In 1908, goldstein first described this syndrome as a type of apraxia with the feeling of estrangement between the patient and his hand. We hypothesized that voluntary motor control in this condition could improve by restoring the congruency between motor. Her left hand, and occasionally her left leg, behaves as if. Three varieties of alien hand syndrome have been reported, involving lesions of the corpus callosum alone, the corpus callosum plus dominant medial frontal. Alien hand syndrome ahs is a rare disorder of involuntary limb movement together with a sense of loss of limb ownership. Although several studies have reported on patients with alien hand syndrome since goldsteins initial description,1 all but three were due to frontal or anterior callosal lesions.
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