PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of jnnpsycJournal of Neurology, Neurosurgery and PsychiatryVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
 
J Neurol Neurosurg Psychiatry. 1992 September; 55(9): 806–810.
PMCID: PMC1015106

The alien hand and related signs.

Abstract

Alien limb sign includes failure to recognise ownership of one's limb when visual cues are removed, a feeling that one body part is foreign, personification of the affected body part, and autonomous activity which is perceived as outside voluntary control. Although the hand is most frequently affected, any limb or combination of limbs may fulfil the alien limb criteria. Alien hand sign should be reserved for cases in which the hand feels foreign together with observable involuntary motor activity. To characterise this phenomenon, seven patients with alien hand sign and other motor or behavioural manifestations are described. Aetiologies included multiple infarcts and cortobasal ganglionic degeneration (CBD). In this study, all patients had apraxia in response to verbal commands and problems with bimanual coordination. Most displayed non-goal directed involuntary motor activities, and two had self destructive motor behaviours. Grasp reflex occurred with alien hand due to either aetiology. Cortical reflex myoclonus was frequently seen in CBD patients. The phenomenological spectrum is reviewed, a diagnostic protocol proposed, and possible anatomical bases of alien hand discussed.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (961K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Brion S, Jedynak CP. Troubles du transfert interhémisphérique (callosal disconnection). A propos de trois observations de tumeurs du corps calleux. Le signe de la main étrangére. Rev Neurol (Paris) 1972 Apr;126(4):257–266. [PubMed]
  • Shahani B, Burrows PT, Whitty CW. The grasp reflex and perseveration. Brain. 1970;93(1):181–192. [PubMed]
  • Goldberg G, Mayer NH, Toglia JU. Medial frontal cortex infarction and the alien hand sign. Arch Neurol. 1981 Nov;38(11):683–686. [PubMed]
  • McNabb AW, Carroll WM, Mastaglia FL. "Alien hand" and loss of bimanual coordination after dominant anterior cerebral artery territory infarction. J Neurol Neurosurg Psychiatry. 1988 Feb;51(2):218–222. [PMC free article] [PubMed]
  • Watson RT, Heilman KM. Callosal apraxia. Brain. 1983 Jun;106(Pt 2):391–403. [PubMed]
  • Starkstein SE, Berthier ML, Leiguarda R. Disconnection syndrome in a right-handed patient with right hemispheric speech dominance. Eur Neurol. 1988;28(4):187–190. [PubMed]
  • Leiguarda R, Starkstein S, Berthier M. Anterior callosal haemorrhage. A partial interhemispheric disconnection syndrome. Brain. 1989 Aug;112(Pt 4):1019–1037. [PubMed]
  • Banks G, Short P, Martinez J, Latchaw R, Ratcliff G, Boller F. The alien hand syndrome. Clinical and postmortem findings. Arch Neurol. 1989 Apr;46(4):456–459. [PubMed]
  • Tanaka Y, Iwasa H, Yoshida M. Diagonistic dyspraxia: case report and movement-related potentials. Neurology. 1990 Apr;40(4):657–661. [PubMed]
  • Levine DN, Rinn WE. Opticosensory ataxia and alien hand syndrome after posterior cerebral artery territory infarction. Neurology. 1986 Aug;36(8):1094–1097. [PubMed]
  • Gibb WR, Luthert PJ, Marsden CD. Corticobasal degeneration. Brain. 1989 Oct;112(Pt 5):1171–1192. [PubMed]
  • Riley DE, Lang AE, Lewis A, Resch L, Ashby P, Hornykiewicz O, Black S. Cortical-basal ganglionic degeneration. Neurology. 1990 Aug;40(8):1203–1212. [PubMed]
  • Alexander MP, Benson DF, Stuss DT. Frontal lobes and language. Brain Lang. 1989 Nov;37(4):656–691. [PubMed]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Group