Posterior Variant of Alien Limb Syndrome with Sudden Clinical Onset as Self-Hitting Associated with Thalamic Stroke

Russo, Mirella; Carrarini, Claudia; Stefano, Vincenzo Di; Angelis, Maria Vittoria De; Onofrj, Marco; Sensi, Stefano L.

doi:10.1159/000503857

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…1 2 AchA strokes most commonly present as a triad of hemiparesis, hemianaesthesia and hemianopia but a wide variety of other clinical manifestations have been reported including abnormal movements presenting as new-onset parkinsonism, one example of tonic spasms, and a recent report of a posterior variant of alien limb syndrome. [3][4][5] To our knowledge, our patient is the first example of choreoathetosis in the setting of AchA ischaemic stroke.…”

Section: Descriptionmentioning

confidence: 73%

Anterior choroidal artery infarct presenting as right hemichoreoathetosis

et al. 2020

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Section: Descriptionmentioning

confidence: 73%

Anterior choroidal artery infarct presenting as right hemichoreoathetosis

et al. 2020

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“…The existence of callosal and frontal subtypes has been suggested ([ 2 , 5 ] for a revision of the literature). In addition, although less frequent, AHS has been described after damage to the posterior cortical regions [ 2 , 13 , 48 , 49 , 50 ] or subcortical lesions [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of White Matter Disconnection in the Symptoms Relating to the Anarchic Hand Syndrome: A Single Case Study

et al. 2021

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The anarchic hand syndrome refers to an inability to control the movements of one’s own hand, which acts as if it has a will of its own. The symptoms may differ depending on whether the brain lesion is anterior, posterior, callosal or subcortical, but the relative classifications are not conclusive. This study investigates the role of white matter disconnections in a patient whose symptoms are inconsistent with the mapping of the lesion site. A repeated neuropsychological investigation was associated with a review of the literature on the topic to identify the frequency of various different symptoms relating to this syndrome. Furthermore, an analysis of the neuroimaging regarding structural connectivity allowed us to investigate the grey matter lesions and white matter disconnections. The results indicated that some of the patient’s symptoms were associated with structures that, although not directly damaged, were dysfunctional due to a disconnection in their networks. This suggests that the anarchic hand may be considered as a disconnection syndrome involving the integration of multiple antero-posterior, insular and interhemispheric networks. In order to comprehend this rare syndrome better, the clinical and neuroimaging data need to be integrated with the clinical reports available in the literature on this topic.

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“…The latter variant sometimes appeared misspelled in the literature as "diagnostic dyspraxia" (13,16), rather than the original "diagonistic" (12). However, this categorization appears to be not exhaustive, as parietal damage was found in patients presenting with limb levitation (20)(21)(22)(23), and thalamic acute lesions may present with features of the posterior variant of AL (i.e., levitation movement of the affected limb and sense of extraneousness), despite the preservation of parietal areas (24)(25)(26). Figure 1 shows relevant brain areas involved in AL.…”

Section: Alien Limb Phenomenologymentioning

confidence: 99%

A Critical Review of Alien Limb-Related Phenomena and Implications for Functional Magnetic Resonance Imaging Studies

et al. 2021

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Consensus criteria on corticobasal degeneration (CBD) include alien limb (AL) phenomena. However, the gist of the behavioral features of AL is still “a matter of debate.” CBD-related AL has so far included the description of involuntary movements, frontal release phenomena (frontal AL), or asomatognosia (posterior or “real” AL). In this context, the most frequent symptoms are language and praxis deficits and cortical sensory misperception. However, asomatognosia requires, by definition, intact perception and cognition. Thus, to make a proper diagnosis of AL in the context of CBD, cognitive and language dysfunctions must be carefully verified and objectively assessed. We reviewed the current literature on AL in CBD and now propose that the generic use of the term AL should be avoided. This catchall AL term should instead be deconstructed. We propose that the term AL is appropriate to describe clinical features associated with specific brain lesions. More discrete sets of regionally bound clinical signs that depend on dysfunctions of specific brain areas need to be assessed and presented when posing the diagnosis. Thus, in our opinion, the AL term should be employed in association with precise descriptions of the accompanying involuntary movements, sensory misperceptions, agnosia-asomatognosia contents, and the presence of utilization behavior. The review also offers an overview of functional magnetic resonance imaging-based studies evaluating AL-related phenomena. In addition, we provide a complementary set of video clips depicting CBD-related involuntary movements that should not mistakenly be interpreted as signs of AL.

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Posterior Variant of Alien Limb Syndrome with Sudden Clinical Onset as Self-Hitting Associated with Thalamic Stroke

Cited by 5 publications

References 17 publications

Anterior choroidal artery infarct presenting as right hemichoreoathetosis

Anterior choroidal artery infarct presenting as right hemichoreoathetosis

The Role of White Matter Disconnection in the Symptoms Relating to the Anarchic Hand Syndrome: A Single Case Study

A Critical Review of Alien Limb-Related Phenomena and Implications for Functional Magnetic Resonance Imaging Studies

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