Alien Hand Syndrome in Stroke: Case Report & Neurophysiologic Study.
10.5535/arm.2012.36.4.556
- Author:
Yong Won PARK
1
;
Chang Hwan KIM
;
Myeong Ok KIM
;
Hyung Joon JEONG
;
Han Young JUNG
Author Information
1. Department of Rehabilitation Medicine, Inha University College of Medicine, Incheon 400-711, Korea. rmjung@inha.ac.kr
- Publication Type:Case Report
- Keywords:
Alien hand syndrome;
Anterior cerebral artery infarction;
Neurophysiologic studies
- MeSH:
Alien Hand Syndrome;
Anterior Cerebral Artery;
Corpus Callosum;
Emigrants and Immigrants;
Extremities;
Female;
Hand;
Hand Strength;
Hemiplegia;
Humans;
Infarction;
Infarction, Anterior Cerebral Artery;
Male;
Motor Activity;
Movement Disorders;
Neurophysiology;
Stroke;
Transcranial Magnetic Stimulation;
Upper Extremity
- From:Annals of Rehabilitation Medicine
2012;36(4):556-560
- CountryRepublic of Korea
- Language:English
-
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.
