ABSTRACT
Objective To report the clinical characteristics of alien hand syndrome(AHS). Methods Eight AHS inpatients from July,2015 to July,2017 were reviewed from the etiology,clinical manifestations, imaging characteristics and outcome. Results The etiology of the patients was cerebrovascular disease. The clinical features included alien hand (8 cases), movement disorder(8 cases),cognitive disorder(5 cases),speech disorder(4 cases)and affective disorder(3 cas-es).Imaging indicated the lesions involved callosum(8 cases),frontal lobe(2 cases),parietal lobe(3 cases),tem-poral lobe(2 cases)and basal ganglial region(1 case).There were four cases healing,two improving,two of re-mission after medicine and rehabilitation. Conclusion ASH is mainly resulted from cerebrovascular disease, in which callosum and frontal lobe are mostly in-volved,features in different forms,and prognoses well.
ABSTRACT
Objective To study the clinical characteristics and imaging features of alien hand syndrome (AHS). Methods We retrospectively analyzed the clinical data of 3 typical cases in our hospital,in comparison with case reports and reviews of domestic and foreign during the past decade. Result All 3 patients showed corpus callosum lesions from CT or MRI detections. The symptoms of the patients included alien hand sign , abnormal involuntary movements, intermanual conflict of upper limbs, and so on. And the patients accompanied with emotional and cognitive changes. Two of them were improved in different degrees after treatment. Conclusion AHS was a complex disease. The diagnosis of this syndrome was based on the advanced neuroimaging. There was still no well established treatment for AHS.
ABSTRACT
Alien hand syndrome (AHS) is a rare neurologic disorder in which movements are performed without conscious will. Cognitive rehabilitation is usually first considered for treating AHS. However, we proposed different modalities for the treatment. This is the first case report showing therapeutic effects of the NEURO-15 program that consists of low-frequency repetitive transcranial magnetic stimulation and intensive occupational therapy on AHS symptoms and upper limb dysfunction caused by a stroke one year and three months before. A 68-year-old male developed right upper limb palsy secondary to cerebral infarction on the medial side of the left frontal lobe. On admission, he exhibited disturbed skilled motor behavior, compulsive grasping of the right upper limb, and dissociated behavior of the right hand independent from the left. The right hand interfered with the actions executed by the left hand. The left hand restricted the right hand in its actions by holding it. Six months after the onset, his Activities of Daily Living improved and he was discharged from hospital to home. However, his compulsive grasping of the right upper limb symptoms remained, and he underwent NEURO-15 one year and three months after the onset. His right upper limb function improved. Compulsive grasping of the right upper limb disappeared, and the contradictory action of the right upper limb was rarely seen. These results suggested that NEURO-15 influenced the neural network including the primary motor cortex and supplementary motor area.
ABSTRACT
Alien Hand Syndrome is defined as unwilled, uncontrollable, but seemingly purposeful movements of an upper limb. 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. After a cerebrovascular accident in the corpus callosum, the parietal, or frontal regions, various abnormal involuntary motor behaviors may follow. Although different subtypes of Alien Hand Syndrome have been distinguished, this classification clearly does not cover the wide clinical variety of abnormal motor behaviors of the upper extremity. And there are few known studies about the neurophysiology of this syndrome using transcranial magnetic stimulation (TMS). We recently experienced 2 rare cases of Alien Hand Syndrome which occurred after anterior cerebral artery (ACA) infarction. A 72 year-old male with right hemiplegia following a left ACA infarct had difficulty with voluntarily releasing an object from his grasp. A 47 year-old female with left hemiplegia following a right ACA infarct had a problem termed 'intermanual conflict' in which the two hands appear to be directed at opposing purposes. Both of them had neurophysiologic studies done, and showed reduced amplitude by single pulse MEP and a lack of intracortical inhibition (ICI) by paired pulse TMS. No abnormalities were found in SSEP.
Subject(s)
Female , Humans , Male , Alien Limb Phenomenon , Anterior Cerebral Artery , Corpus Callosum , Emigrants and Immigrants , Extremities , Hand , Hand Strength , Hemiplegia , Infarction , Infarction, Anterior Cerebral Artery , Motor Activity , Movement Disorders , Neurophysiology , Stroke , Transcranial Magnetic Stimulation , Upper ExtremityABSTRACT
Various movement disorders associated with cerebral infarction have been introduced. However patients with anterior cerebral artery territory infarction presenting with hemichoreoballism have never been reported. We present a 64-year-old man with hemichoreoballism and frontal alien hand syndrome on his right hand. Diffusion weighted brain MRI revealed hyperintensities in anterior two third of corpus callosum and superior frontal gyrus. Hemichoreoballism was improved after one day treated by clonazepam. We report the case with hemichoreoballism after anterior cerebral artery territory infarction.