Dataset Information

Diagonistic [corrected] Apraxia and Ictal Alien Hand.

ABSTRACT: Alien hand is a strangely behaving hand and occurs in disease of medial frontal lobe and also corpus callosum. When it is with frontal lobe disease, it manifests as groping and hooking with either hand, but callosal lesions produce left-hand abnormalities of varying degrees. Occasionally this phenomenon can be transient as an ictal manifestation. Case 1 is a 20-year-old female who was on treatment for panic and anxiety for 4 years and later noticed strange action by the left hand pushing food plate and notebook when she is using them with the right hand. Case 2 is a 14-year-old boy who presented with episodes of strange situation where his left hand was pushing his right hand into his mouth, and he had no control over it. He bit his right-hand fingers, and on one episode, he was bleeding from his injured fingers, yet he felt someone is making his left hand do this. Both patients had a demonstrable structural lesion. Patients, when they have stereotyped strange behavior with limbs, need to be investigated for organic disease and initiate treatment accordingly.

SUBMITTER: Chandra SR

PROVIDER: S-EPMC5968654 | biostudies-literature | 2018 May-Jun

REPOSITORIES: biostudies-literature

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Diagonistic [corrected] Apraxia and Ictal Alien Hand.

Chandra Sadanandvalli Retnaswami SR Teja Karu Venkata Ravi KVR Sheshadri Roopa R

Indian journal of psychological medicine 20180501 3

Alien hand is a strangely behaving hand and occurs in disease of medial frontal lobe and also corpus callosum. When it is with frontal lobe disease, it manifests as groping and hooking with either hand, but callosal lesions produce left-hand abnormalities of varying degrees. Occasionally this phenomenon can be transient as an ictal manifestation. Case 1 is a 20-year-old female who was on treatment for panic and anxiety for 4 years and later noticed strange action by the left hand pushing food pl ...[more]

PMID: 29875540

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Project description:Alien hand syndrome (AHS) is a neurological illness characterized by limb movements which are carried out without being aware of it. Many patients describe these movements as aggressive and some perceive a strong feeling of estrangement and go so far as to deny ownership. The sense of body ownership is the perception that parts of one's body pertain to oneself, despite it is moving or not and if movement is intentional or unintentional. These anomalous self-experiences may arise in patients with focal brain lesions and provide unique opportunities to disclose the neural components underlying self-body perception. The feeling of foreignness described in AHS is often observed in post-central cortical lesions in the non-dominant hemisphere and is typical of the "posterior alien hand variant". We used Diffusion-Tensor magnetic resonance imaging (DT-MRI) in an unusual case of posterior AHS of the dominant hand in a professional pianist with corticobasal syndrome (CBS). The patient showed uncontrolled levitation with the right arm while playing the piano and perceived as if her hand had a "mind of its own" which prevented her from playing. MRI-scans show asymmetric brain atrophy, mainly involving left post-central regions and SPECT-Tc99m-ECD patterns of hypometabolism over the left parietal-occipital cortices. DT-MRI revealed extensive damage which comprised left fronto-temporal cortex and extends into the ipsilateral parietal cortex causing a disruption of corpus callosum (CC) projections from the rostrum to the splenium. Our case illustrates that posterior AHS may occur in the dominant hemisphere due to widespread damage, which exceed parietal cortex. The parietal lobe has been recognized as a multimodal association region that gets input from several networks and organizes motor output. We suggest that the disturbance to this pathway could result in disruption of motor output and associate an abnormal motor control and anomalous self-body perception.

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Dataset Information

Diagonistic [corrected] Apraxia and Ictal Alien Hand.

Publications

Diagonistic [corrected] Apraxia and Ictal Alien Hand.

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