Paroxysmal posterior variant alien hand syndrome associated with parietal lobe infarction: case presentation

Abstract

Alien hand syndrome (AHS) is an involuntary and rare neurological disorder emerges at upper extremity. AHS is a disconnection syndrome with the symptoms of losing sense of agency and sense of ownership, and presence of involuntary autonomic motor activity. There are frontal, callosal and posterior types of AHS and each of them occurs depend on the lesions of different of the brain. Posterior variant is a rarely encountered AHS type compared to others. AHS, generally regarded as persistent, but rarely maybe observed as paroxysmal. In this article, we present 71 year old patient with right posterior parietal lobe infarction and developed posterior variant AHS on left arm 1 month after discharge from the hospital. To discriminate AHS from conditions such as extrapyramidal movement disorders and epileptic seizures that take part in differential diagnosis should be kept in mind by the clinicians. Wrong and unnecessary treatments could be prevented in this way.

Keywords: Alien hand syndrome; Parietal lobe; Posterior type; Stroke.

Fig. 1

Cranial CT of case: right posterior parietal lobe enfact was shown. CT computed tomography

Fig. 2

Diffusion MRI (a, b) and T1 MRI (c, d) of case: right posterior parietal lobe enfact was shown. MRI magnetic resonance image