The Stroke that Struck Back: An Unusual Alien Hand Presentation

Spector, Andrew R.; Freeman, William D.; Cheshire, William P.

doi:10.1016/j.jstrokecerebrovasdis.2008.08.003

Cited by 14 publications

(7 citation statements)

References 7 publications

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“…Subacute onset is most common, seen with neurodegenerative disorders [12]. Sudden onset AHS may occur with a stroke [35,36]. It may be the first presenting sign of CJD followed by other classical findings [32•].…”

Section: Clinical Symptoms/signsmentioning

confidence: 99%

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Alien Hand Syndrome

Hassan

Josephs

2016

Curr Neurol Neurosci Rep

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Alien hand syndrome (AHS) is a rare disorder of involuntary limb movement together with a sense of loss of limb ownership. It most commonly affects the hand, but can occur in the leg. The anterior (frontal, callosal) and posterior variants are recognized, with distinguishing clinical features and anatomical lesions. Initial descriptions were attributed to stroke and neurosurgical operations, but neurodegenerative causes are now recognized as most common. Structural and functional imaging and clinical studies have implicated the supplementary motor area, pre-supplementary motor area, and their network connections in the frontal variant of AHS, and the inferior parietal lobule and connections in the posterior variant. Several theories are proposed to explain the pathophysiology. Herein, we review the literature to update advances in the understanding of the classification, pathophysiology, etiology, and treatment of AHS.

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Section: Clinical Symptoms/signsmentioning

confidence: 99%

“…They may hit it, admonish it, or personify it as Bmischievous.^They may not perceive it not as their own, thus truly alien [14]. Rarely, they may be frightened by it [35,36].…”

Section: Clinical Symptoms/signsmentioning

confidence: 99%

Alien Hand Syndrome

Hassan

Josephs

2016

Curr Neurol Neurosci Rep

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“…23 Patients with parietal or thalamic lesions may have significant sensory deficits without weakness. 24 The affected hand can also have unusual postures with the digits hyperextended and the palmar surface pulling away from approaching objects.…”

Section: Anterior Variantsmentioning

confidence: 99%

Pathophysiology and Treatment of Alien Hand Syndrome

Sarva¹,

Deik

Severt

2014

Tremor and Other Hyperkinetic Movements

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Background: Alien hand syndrome (AHS) is a disorder of involuntary, yet purposeful, hand movements that may be accompanied by agnosia, aphasia, weakness, or sensory loss. We herein review the most reported cases, current understanding of the pathophysiology, and treatments. Methods: We performed a PubMed search in July of 2014 using the phrases ''alien hand syndrome,'' ''alien hand syndrome pathophysiology,'' ''alien hand syndrome treatment,'' and ''anarchic hand syndrome.'' The search yielded 141 papers (reviews, case reports, case series, and clinical studies), of which we reviewed 109. Non-English reports without English abstracts were excluded. Results: Accumulating evidence indicates that there are three AHS variants: frontal, callosal, and posterior. Patients may demonstrate symptoms of multiple types; there is a lack of correlation between phenomenology and neuroimaging findings. Most pathologic and functional imaging studies suggest network disruption causing loss of inhibition as the likely cause. Successful interventions include botulinum toxin injections, clonazepam, visuospatial coaching techniques, distracting the affected hand, and cognitive behavioral therapy. Discussion: The available literature suggests that overlap between AHS subtypes is common. The evidence for effective treatments remains anecdotal, and, given the rarity of AHS, the possibility of performing randomized, placebo-controlled trials seems unlikely. As with many other interventions for movement disorders, identifying the specific functional impairments caused by AHS may provide the best guidance towards individualized supportive care.

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“…The present ALS case is intriguing as the condition showed by the patient had an acute onset and was triggered by an isolated thalamic stroke, an uncommon ALS feature [2,[4][5][6][7]. ALS is usually subacute and occurs days or weeks after the appearance of motor deficits or other stroke-related symptoms [2,8,9].…”

Section: Discussionmentioning

confidence: 86%

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

et al. 2020

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We present a case of sudden postischaemic onset of alien limb syndrome, with unintentional self-injury. Alien limb syndrome is an uncommon neurological disorder featured by uncontrolled and involuntary movements of a limb. Three variants of alien limb syndrome have been described: the anterior, featured by grasping of surrounding objects, the callosal, presenting with intermanual conflict, and the posterior, associated with involuntary levitation of the limb. Our patient suffered from an acute presentation of the posterior variant of the alien limb syndrome, resulting from an isolated thalamic stroke which was documented using 24-h Case

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The Stroke that Struck Back: An Unusual Alien Hand Presentation

Cited by 14 publications

References 7 publications

Alien Hand Syndrome

Alien Hand Syndrome

Pathophysiology and Treatment of Alien Hand Syndrome

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

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