Pathophysiology and Treatment of Alien Hand Syndrome

Sarva, Harini; Deik, Andres Lawrence; Severt, William Lawrence

doi:10.7916/d8vx0f48

Cited by 21 publications

(7 citation statements)

References 101 publications

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“…7 Distress arises from the perception of onlookers, features of which were elicited in our patient. 8 Hence, our patient had features of both anterior and posterior types of alien limb syndrome, which could be explained by diffuse involvement of the corpus callosum in the inciting event. 9 The corpus callosum is the major commissural pathway connecting the cerebral hemispheres and it receives its blood supply from the pericallosal artery (branch of anterior cerebral artery) and posterior pericallosal artery (branch of the posterior cerebral artery).…”

Section: Discussionmentioning

confidence: 71%

“…Patients with callosal type alien hand syndrome can also exhibit autocriticism (frustration caused by intermanual conflict). 8 On the other hand, visuospatial deficits elicited in history and the impaired cortical sensations over her left hand on examination were suggestive of a posterior alien limb phenomenon, pertaining to lesions of contralateral occipito-parietal cortex, splenium of corpus callosum, or thalamus. 7 Distress arises from the perception of onlookers, features of which were elicited in our patient.…”

Section: Discussionmentioning

confidence: 96%

“…7 Distress arises from the perception of onlookers, features of which were elicited in our patient. 8…”

Section: Discussionmentioning

confidence: 99%

“…Medications, which have been used, include clonazepam and botulinum toxin. 2,7,8 Behavioral therapy, for example, distracting the hand with some object while the normal hand is free to perform activities, retraining the person to recognize shapes, objects, directions, and applying learned skills to daily life later, have shown some effect. 2,7,8…”

Section: Discussionmentioning

confidence: 99%

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Alien Limb Phenomenon After Diffuse Corpus Callosum Ischemic Stroke

Sarkar

Ray

Mukherjee

et al. 2022

The Neurohospitalist

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The alien limb is a phenomenon characterized by a cluster of clinical features wherein the limb behaves autonomously and as separated from a person’s identity. We herein report a 36-year-old Indian female with multiple comorbidities who presented with recurrent episodes of limb-shaking transient ischemic attacks for 1 year, followed by left-sided hemiplegia. During recovering, the patient noticed a feeling that as if her left hand did not belong to herself and acted autonomously (alien limb phenomenon) along with visuospatial deficits. Magnetic resonance imaging of the brain revealed ischemic stroke diffusely involving corpus callosum. Magnetic resonance angiography was suggestive of compromised right-sided anterior circulation. This was corroborated by digital subtraction angiography that revealed reduced flow in right internal carotid artery. Diffuse infarction of the corpus callosum requires involvement of both the anterior and the posterior circulation. Due to the lack of clinical features suggestive of chronic internal carotid artery dissection, occlusive atherosclerotic disease of the anterior cerebral circulation associated with possible steal phenomenon from the posterior circulation was the most probable underlying mechanism for the callosal stroke. Steal phenomenon has been proposed as a compensatory mechanism in hemodynamically compromised ischemic parenchyma and it can explain the co-existence of anterior and posterior circulation strokes. This case also highlights how both anterior and posterior types of the alien limb phenomenon can co-exist in a background of vascular insult, resulting from intra-cranial atherosclerotic disease.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 96%

“…7 Distress arises from the perception of onlookers, features of which were elicited in our patient. 8…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Alien Limb Phenomenon After Diffuse Corpus Callosum Ischemic Stroke

Sarkar

Ray

Mukherjee

et al. 2022

The Neurohospitalist

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“…Parietal lobe lesions tend to produce a feeling that the affected hand/arm is alien. Loss of somatosensory inputs to the primary motor area may produce the bizarre posturing of the arm, such as arm levitation 9…”

Section: Discussionmentioning

confidence: 99%

Alien-hand syndrome with mirror movements in hereditary diffuse leukoencephalopathy with spheroids

et al. 2022

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Hereditary diffuse leukoencephalopathy with spheroids is a rare genetic disorder caused by mutations of the colony-stimulating factor 1 receptor gene. It is an adult-onset leukodystrophy, with a wide spectrum of neurological and psychiatric manifestations that includes Parkinsonism, dementia, seizures, limb weakness, spasticity and abnormal motor behaviour. Alien-hand syndrome and mirror movements are rare manifestations of this and other neurodegenerative disorders. We describe a woman with progressive limb and trunk rigidity, Parkinsonism and dementia, who also had involuntary left arm levitation (part of the posterior variant of alien-hand syndrome) and left-hand mirror movements. We discuss the different types of alien-hand syndrome, and the likely mechanisms of arm levitation and mirror movements.

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Corticobasal Syndrome (CBS)

Frucht,

Termsarasab

2024

Movement Disorders Phenomenology

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Pathophysiology and Treatment of Alien Hand Syndrome

Cited by 21 publications

References 101 publications

Alien Limb Phenomenon After Diffuse Corpus Callosum Ischemic Stroke

Alien Limb Phenomenon After Diffuse Corpus Callosum Ischemic Stroke

Alien-hand syndrome with mirror movements in hereditary diffuse leukoencephalopathy with spheroids

Corticobasal Syndrome (CBS)

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