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Alien Hand Syndrome -

Bizarre neurological disorder of the anarchic hand with a life of its own.

 Dr Sampurna Roy MD  

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I was typing with both my hands and sliding my finger on the touchpad to move the cursor.

Then I extended my right hand picked up the coffee mug and had a sip of coffee.

Both my hands were making coordinated movements exactly the way I wanted.

Now imagine these terrifying situations when suddenly your hands feel foreign to you and you have no control over its weird movements.

You hold a coffee mug with one hand and before you can take a sip the other hand grabs it and throws it on the floor.

While sleeping in the night you wake up gasping and much to your horror you find that your own hand is trying to throttle you.

You are out for a pleasant morning walk with your friend and you suddenly turn around and slap him on the face.

You begin to wonder whether the hand belongs to you or to an alien.

The name of this stange neurological disorder is Alien Hand Syndrome.

The disease was first discovered in 1908 by a German neurologist, Kurt Goldstein.

 The name Alien Hand Syndrome was given by Joseph Bogen. (The callosal syndromes. in Clinical neuropsychology. eds Heilman KM, Valenstein E (Oxford University Press, New York), 3rd ed. pp 337407.(1993) Bogen JE)

It is sometimes called Dr. Strangelove syndrome based on the strange hand movements of the main character of the movie Dr. Strangelove.

It is an excellent black comedy directed by Stanley Kubrick, starring Peter Sellers and George C. Scott.

In the movie Dr Stragelove had no control on his right hand and made strange movements like raising his black-gloved right hand into Nazi salutes or trying to throttle his own neck.

Alien hand syndrome is defined as an unwilled, uncontrollable, but purposeful movements of an upper limb that the patients feel does not belong to them.

They are under the impression that it is being controlled by an external force.

Autocriticism, is a commonly noted feature in this condition.

The patients often criticize and show astonished frustration with the behavior of the uncontrolled limb. 

In one case a patient with left alien hand syndrome showed bizarre leg symptoms like walking straight ahead and not stopping even on command.

There was clear lack of coordination between verbal suggestion and motor response of his legs.

He walked away to unintended places and could not remember why and how he reached the place.

This is mainly due to disconnection between his mind and action.

While walking sometimes he would suddenly stand still or stick to the ground for a brief period.

Alien hand syndrome occurs in patients where the two brain hemispheres are surgically separated or when there is an infection in brain after a surgery.

This syndrome can also occur after infections, strokes, or surgery of any brain area  besides of the hemispheres.

 

Different lobes of the brain

Due to damage of the nerves that connects the left and the right hemisphere of the brain, the information doesn’t pass from one hemisphere to another.

The patients affected by alien hand syndrome are not able to take control of their  affected hand.

In patients with damage to the corpus callosum, the hands appear to be acting in opposition to each other. 

This phenomenon is called "intermanual conflict".

Three varieties of alien hand syndrome have been reported:

1) Lesions of the corpus callosum ,

2) The corpus callosum and medial frontal cortex of the dominant hemisphere

3) Posterior cortical and subcortical areas.

Frontal alien hand syndrome occurs in the dominant hand and is associated with reflexive grasping, groping, and  compulsive manipulation of tools.

It results from damage to the supplementary motor area, anterior cingulate gyrus, and medial prefrontal cortex of the dominant hemisphere and anterior corpus callosum.

Callosal alien hand syndrome is characterized mainly by intermanual conflict and requires only an anterior callosal lesion.

Various theories have been proposed about alien hand syndrome.

It is suggested that due to brain damage, the primary motor cortex that control hand movements is isolated from premotor influences but itself remains intact, so is able to execute hand movements.

There may be  multiple foci of cortical dysfunction (cortical and subcortical) caused by single or multiple infarcts which may produce symptoms of alien hand syndrome.

Posterior alien hand syndrome has also been reported in a patient with right thalamic infarct.

 

Alien hand syndrome is rare but an important neurological disorder because of its disabling impact on the daily life.

The rehabilitative treatment can drastically improve activities of daily life.  Doctor are

 

On a lighter note, imagine walking down a dark road when an alien hand from somewhere tries to throttle you, punches you on the face or pushes you on the ground with one hand.

Scary situation!! There is always that rare possibility that the attacking anarchic hand has a strange life of its own and is not under voluntary control of the suffering person standing before you. 

Happy Halloween Day!

 

Further reading

Dr. Strangelove syndrome.

Alien hand syndrome in stroke - case report & neurophysiologic study

Corpus callosum hematoma secondary to cerebral venous malformation presenting as alien hand syndrome.

Waking up the alien hand: rubber hand illusion interacts with alien hand syndrome.

Leg manifestation in alien hand syndrome.

Compulsive grasping hand syndrome: a variant of anarchic hand

Alien hand syndrome: a review of the literature.

Opticosensory ataxia and alien hand syndrome after posterior cerebral artery territory infarction.

When aliens invade: multiple mechanisms for dissociation between will and action

Posterior alien hand syndrome after a right thalamic infarct.

Subjective experience, involuntary movement, and posterior alien hand syndrome.

 

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Dr  Sampurna Roy  MD

Consultant Histopathologist (Kolkata - India)

 

 


 

 

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