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Review
. 2024 Oct;45(10):4669-4677.
doi: 10.1007/s10072-024-07626-1. Epub 2024 Jun 4.

When the diagnosis is in the patient's hand and in the neurologist's eye

Alessandro Bertini  1   2 , Sveva Lenti  1   2 , Giorgia Libelli  3 , Riccardo Ronco  1   2 , Serena Oliveri  1   2 , Kora Montemagno  1 , Alberto Priori  1   2 , Tommaso Bocci  4   5
Affiliations
Review

When the diagnosis is in the patient's hand and in the neurologist's eye

Alessandro Bertini et al. Neurol Sci. 2024 Oct.

Abstract

The objective of this study was to encompass current knowledge about pathophysiological mechanisms of those specific hand postures or deformities caused by central nervous system disorders. In the era of high-resolution neuroimaging and molecular biology, clinicians are progressively losing confidence with neurological examination. Careful hand observation is of key importance in order to differentiate neurological from non-neurological conditions, central from peripheral aetiologies, and organic from functional disorders. Localizing the potential anatomical site is essential to properly conduct subsequent exams. We provided a practical guide for clinicians to recognize hand patterns caused by central nervous system disorders, avoiding mimicking conditions, thus optimizing and prompting the diagnostic pathway.

Keywords: Alien hand; Neurological diagnosis; Parietal hand; Pseudoperipheral hands; Split hand; Thalamic hand.

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Conflict of interest statement

Authors do not have any financial or non-financial interest, directly or indirectly related to this work.

Figures

Fig. 1
Fig. 1
Neurological hands. Pseudoradial hand (A), Alien hand, posterior variant (B), Thalamic hand, pseudochoreoathetotic variant (C), Striatal hand (D), “Pincer” hand (E), “Fist” hand (F), Clenched fist hand (G)
See this image and copyright information in PMC

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