Alien hand syndrome

A neurological disorder characterized by involuntary hand movements

Alien hand syndrome
Synonyms	AHS, alien limb syndrome, ALS (not to be confused with amyotrophic lateral sclerosis), Dr. Strangelove syndrome
Pronounce	N/A
Specialty	N/A
Symptoms	Involuntary, purposeful movement of one hand; the hand may act without conscious control, often performing actions contrary to the person's intent
Complications	Emotional distress, social embarrassment, difficulty performing coordinated tasks
Onset	Typically sudden, often after brain surgery, stroke, or trauma
Duration	May be persistent or episodic
Types	Frontal (motor type), callosal (intermanual conflict), and posterior (sensory type)
Causes	Lesions in the corpus callosum, frontal lobe, or parietal lobe; stroke, neurosurgery, neurodegenerative diseases such as Creutzfeldt–Jakob disease or Alzheimer's disease
Risks	Brain surgery (especially corpus callosotomy), stroke, neurodegeneration
Diagnosis	Clinical evaluation, MRI or CT scan to identify lesion location
Differential diagnosis	Seizure disorder, conversion disorder, chorea, hemiballismus
Prevention	No known prevention
Treatment	Supportive therapy, cognitive behavioral therapy, visual or tactile feedback strategies
Medication	Limited efficacy; some benefit from benzodiazepines or botulinum toxin
Prognosis	Variable; may improve over time, but some cases are persistent
Frequency	Rare
Deaths	Not directly fatal

Alien hand syndrome (AHS) is a rare neurological disorder that causes one hand to act independently of the will of the individual. This condition is also known as anarchic hand syndrome or Dr. Strangelove syndrome. It is characterized by involuntary, yet purposeful, movements of the hand, which can interfere with the individual's daily activities.

Presentation

Individuals with alien hand syndrome experience a loss of control over one of their hands, which seems to act on its own. The affected hand may perform complex movements, such as grasping objects, manipulating tools, or even interfering with the actions of the other hand. Patients often describe the hand as having a "mind of its own."

The syndrome can be distressing, as the hand may perform actions that are contrary to the individual's intentions. For example, the alien hand might unbutton a shirt that the other hand is trying to button, or it might pick up objects and throw them away without the person's conscious intent.

Causes

Alien hand syndrome is most commonly associated with damage to the corpus callosum, the bundle of nerve fibers that connects the two hemispheres of the brain. It can also occur following stroke, brain surgery, or neurodegenerative diseases such as Alzheimer's disease.

The syndrome is thought to result from a disruption in the normal communication between the brain's hemispheres, leading to a lack of coordination and control over the affected hand. In some cases, alien hand syndrome may be associated with lesions in the frontal lobe or parietal lobe of the brain.

Diagnosis

Diagnosis of alien hand syndrome is primarily clinical, based on the observation of involuntary hand movements and the patient's description of their experiences. Neurological examination and neuroimaging techniques, such as MRI or CT scan, may be used to identify any underlying brain lesions or abnormalities.

Management

There is no specific cure for alien hand syndrome, and treatment focuses on managing symptoms and improving the patient's quality of life. Strategies may include:

• Behavioral therapy to help the patient regain some control over the affected hand.
• Occupational therapy to develop strategies for coping with the involuntary movements.
• Use of visual or tactile cues to help the patient become more aware of the hand's actions.

In some cases, medications such as benzodiazepines or botulinum toxin injections may be used to reduce muscle activity in the affected hand.

Prognosis

The prognosis for individuals with alien hand syndrome varies depending on the underlying cause and the extent of brain damage. In some cases, symptoms may improve over time, while in others, they may persist or worsen. Supportive therapies can help patients manage the condition and maintain independence in daily activities.

Related pages

• Neurology
• Corpus callosum
• Frontal lobe
• Parietal lobe
• Stroke
• Alzheimer's disease