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ALIEN HAND SYNDROME, 1994-1996

--- a literature search conducted at Indiana University, Bloomington, Indiana.

Persons with injuries to the brain including, of course, the corpus callosum, sometimes report that one of their limbs, typically an arm, acts as though it belongs to somebody else. Here are the abstracts of 15 recent articles on the subject from the 1994-1996 literature.

Presented with the generous co-operation and permission of SilverPlatter.
PsycINFO Serials 1/94-12/96 1 of 15

TI: Transient left-sided alien hand with callosal and unilateral fronto-mesial damage: A case study.

AU: Papagno,-C.; Marsile,-C.

IN: U di Milano, Clinica Neurologica III, Milano, Italy

SO: Neuropsychologia; 1995 Dec Vol 33(12) 1703-1709

IS: 00283932

LA: English

PY: 1995

AB: Reports the case of a 40-yr-old woman who showed a transient left alien hand after a subarachnoid hemorrhage, due to a ruptured aneurysm of the anterior communicating artery. No left agraphia and left apraxia could be found. A CAT-scan including coronal sections showed a right medial frontal hypodensity and different ischemic lesions in the anterior part of the corpus callosum. The possible anatomic site of the lesion responsible for the permanent form of alien hand is discussed. (PsycINFO Database Copyright 1996 American Psychological Assn, all rights reserved)

KP: transient left alien hand; 40 yr old female with callosal & fronto-mesial damage following ruptured aneurysm of anterior communicating artery; Italy; case report

DE: ANEURYSMS-; BRAIN-DAMAGED; CORPUS-CALLOSUM; FRONTAL-LOBE; HAND-ANATOMY; ADULTHOOD-; CASE-REPORT

CC: 3297; 32

PO: Human

AG: Adult

DT: Journal-Article

UD: 9611

AN: 83-34772

PsycINFO Serials 1/94-12/96 2 of 15

TI: Slowly progressive apraxia in Alzheimer's disease.

AU: Green,-Robert-C.; Goldstein,-F.-C.; Mirra,-S.-S.; Alazraki,-N.-P.; et-al

IN: Wesley Woods Ctr, Neurobehavioral Program, Atlanta, GA, US

SO: Journal-of-Neurology,-Neurosurgery-and-Psychiatry; 1995 Sep Vol 59(3) 312-315

IS: 00223050

LA: English

PY: 1995

AB: Presents a case study of a 66 yr old right handed man, who experienced slow progressive apraxia due to Alzheimer's disease (AD). S's initial impairments included onset of finger hand incoordination, coordinated movements of the left hand and some features of the alien hand syndrome. Detailed neurological examination showed moderately severe agraphaesthesia and astereognosis in the left hand and difficulties with left hand praxis. The execution of transitive and intransitive movements to command was worse with the left hand. Over 4 yrs, the S developed progressively worsening deficits of memory and language. A biopsy of his right temporal lobe showed numerous plaques and neurofibrillary tangles. Pronounced right parietal lobe hypoperfusion on serial SPECT perfusion images suggests involvement of this region in contralateral praxis. (PsycINFO Database Copyright 1996 American Psychological Assn, all rights reserved)

KP: slow progressive apraxia due to Alzheimer's disease; 66 yr old male

DE: APRAXIA-; ALZHEIMERS-DISEASE; AGED-; ADULTHOOD-

CC: 3297; 32

PO: Human

AG: Adult; Elderly

DT: Journal-Article

UD: 9607

AN: 83-20539

PsycINFO Serials 1/94-12/96 3 of 15

TI: Alien hand sign or alien syndrome?

AU: Dolado,-A-Marcos; Castrillo,-C.; Urra,-D.-G.; De-Seijas,-E.-Varela

IN: Hosp Universitario San Carlos, Madrid, Spain

SO: Journal-of-Neurology,-Neurosurgery-and-Psychiatry; 1995 Jul Vol 59(1) 100-101

IS: 00223050

LA: English

PY: 1995

AB: Investigated a case of alien hand syndrome in an 80-yr-old man with a history of acute myocardial infarction and chronic obstructive pulmonary disease. magnetic resonance imaging (MRI) showed recent cortical infarct in the high right parietal region and cortical atrophy of the left parietal. SPECT examination showed left parietal perfusion deficit with hyperfusion on the right parietal. Treatment with ticlopidine improved some symptoms. Diagnosis, history and etiology of the syndrome are considered. (PsycINFO Database Copyright 1996 American Psychological Assn, all rights reserved)

KP: alien hand syndrome; 80 yr old male with acute myocardial infarction & chronic obstructive pulmonary disease; case report

DE: HAND-ANATOMY; SYNDROMES-; MYOCARDIAL-INFARCTIONS; LUNG-DISORDERS; CHRONIC-ILLNESS; ADULTHOOD-; CASE-REPORT; AGED-

CC: 3290; 32

PO: Human

AG: Adult; Elderly

DT: Journal-Article

UD: 9605

AN: 83-14792

PsycINFO Serials 1/94-12/96 4 of 15

TI: Alien hand syndrome: Interhemispheric motor disconnection due to a lesion in the midbody of the corpus callosum.

AU: Geschwind,-Daniel-H.; Iacoboni,-M.; Mega,-M.-S.; Zaidel,-D.-W.; et-al

IN: Reed Neurological Research Ctr, Dept of Neurology, Los Angeles, CA, US

SO: Neurology; 1995 Apr Vol 45(4) 802-808

IS: 00283878

LA: English

PY: 1995

AB: Reports the case of a 68-yr old right-handed woman with a transient alien hand syndrome caused by a stroke limited to the middle and posterior portions of the body of the corpus callosum. This case provides supportive evidence for damage to the midbody of the corpus callosum as the anatomic basis of nondominant alien hand syndrome and conforms to a model of interhemispheric motor disconnection as the essential component of this unusual behavioral syndrome. This disconnection can occur with injuries involving interhemispheric premotor and motor fibers traveling in the midportion of the callosum in individuals with left hemisphere dominance for motor activities. (PsycINFO Database Copyright 1995 American Psychological Assn, all rights reserved)

KP: transient alien hand syndrome; 68 yr old right handed female with stroke to midbody of corpus callosum; case report; implications for interhemispheric motor transfer

DE: APRAXIA-; HAND-ANATOMY; CEREBROVASCULAR-ACCIDENTS; CORPUS-CALLOSUM; INTERHEMISPHERIC-INTERACTION; CASE-REPORT; AGED-; ADULTHOOD-

CC: 3295; 32

PO: Human

AG: Adult; Elderly

DT: Journal-Article

UD: 9512

AN: 82-44381

PsycINFO Serials 1/94-12/96 5 of 15

TI: Alien hand sign in association with Alzheimer's histopathology.

AU: Ball,-J.-A.; Lantos,-P.-L.; Jackson,-M.; Marsden,-C.-D.; et-al

IN: National Hosp for Neurology & Neurosurgery, London, England

SO: Journal-of-Neurology,-Neurosurgery-and-Psychiatry; 1993 Sep Vol 56(9) 1020-1023

IS: 00223050

LA: English

PY: 1993

AB: Presents the case report of a 68-yr-old man with an alien left hand, cortical myoclonus, bilateral parietal lobe dysfunction, and memory impairment, but preserved language skills. The clinical diagnosis was of corticobasal degeneration, but at necropsy, 4 yrs after the onset of symptoms, the pathology was of Alzheimer's disease (AD) with some scattered chromatolytic pale neurons in the cerebral cortex. The alien hand sign is an illustration of the clinical heterogeneity that may occur in association with Alzheimer histopathology. (PsycINFO Database Copyright 1994 American Psychological Assn, all rights reserved)

KP: alien left hand sign; male 68 yr old with Alzheimer's disease

DE: HAND-ANATOMY; ALZHEIMERS-DISEASE; AGED-; ADULTHOOD-

CC: 3297; 32

PO: Human

AG: Adult; Elderly

DT: Journal-Article

UD: 9404

AN: 81-14171

PsycINFO Serials 1/94-12/96 6 of 15

TI: Paroxysmal alien hand syndrome.

AU: Leiguarda,-Ramon; Starkstein,-Sergio; Nogues,-Martin; Berthier,-Marcelo; et-al

IN: Inst of Neurological Research, Buenos Aires, Argentina

SO: Journal-of-Neurology,-Neurosurgery-and-Psychiatry; 1993 Jul Vol 56(7) 788-792

IS: 00223050

LA: English

PY: 1993

AB: Describes 3 male patients (aged 34, 54, and 65 yrs) and 1 female patient (aged 50 yrs) who presented with a paroxysmal form of the alien hand syndrome. Two Ss with damage to one frontomedial cortex had brief episodes of abnormal motor behavior of the contralateral arm that featured groping, grasping, and apparently purposeful but perseverative movements, which both Ss interpreted as alien or foreign. The other 2 Ss, with posterior parietal damage, reported a paroxysmal feeling of unawareness of the location of the contralateral arm, lack of recognition of the arm as their own, purposeless movements, and personification of the arm. These cases represent a new form of the alien hand syndrome manifested by brief, paroxysmal episodes, which may be due to ictal mechanisms. (PsycINFO Database Copyright 1994 American Psychological Assn, all rights reserved)

KP: paroxysmal episodes of alien hand syndrome with contralateral arm; male 34 & 54 & 65 yr olds & female 50 yr old with frontomedial cortex or posterior parietal damage

DE: FRONTAL-LOBE; PARIETAL-LOBE; BRAIN-DAMAGED; HAND-ANATOMY; AGED-; ADULTHOOD-

CC: 3297; 32

PO: Human

AG: Adult; Elderly

DT: Journal-Article

UD: 9403

AN: 81-10312

PsycINFO Serials 1/94-12/96 7 of 15

TI: Alien hand sign.

AU: Gasquoine,-Philip-G.

IN: Rehabilitation Hosp of South Texas, Psychology Dept, Corpus Christi, US

SO: Journal-of-Clinical-and-Experimental-Neuropsychology; 1993 Sep Vol 15(5) 653-667

IS: 01688634

LA: English

PY: 1993

AB: Usage of the term "alien hand sign" is reviewed in 20 published cases. It refers to apparently purposeful, upper-extremity movements that the patient reports are beyond his/her control. Lesions were found in medial frontal cortex and/or the corpus callosum; there was a high co-occurrence of speech hesitation, limb dyspraxia, tactile dysnomia, muscle weakness, and grasp reflex on the alien side. Five behavioral manifestations of alien movement have been described, with grasping movements and intermanual conflict being the most common. Two manifestations, exaggerated ataxic automatisms and drifting movements, likely represent other types of movement disorders. Dysfunction of the supplementary motor area and related structures has been implicated. (PsycINFO Database Copyright 1994 American Psychological Assn, all rights reserved)

KP: behavioral characteristics & co-occurring neurological deficits of alien hand sign & lateralized uncontrolled upper extremity movements; research review

DE: MOVEMENT-DISORDERS; HAND-ANATOMY; LATERAL-DOMINANCE

CC: 3297; 32

PO: Human

DT: Journal-Article

UD: 9402

AN: 81-06347

PsycINFO Serials 1/94-12/96 8 of 15

TI: Behavioral disorders in association with posterior callosal and frontal cerebral infarction.

AU: Lejeune,-J.-P.; Caparros-Lefebvre,-D.

IN: Ctr Hospitalier Regional Universitaire, Lille, France

SO: Behavioural-Neurology; 1993 Spr Vol 6(1) 55-57

IS: 09534180

LA: English

PY: 1993

AB: Presents the case of a 44-yr-old right-handed man in whom behavioral disorders were a prominent clinical feature after the surgical treatment of an anterior communicating artery aneurysm rupture. Callosal apraxia was associated with an alien hand. The latter remained 1 yr after surgery, while diagnostic apraxia disappeared after 3 mo. Other callosal signs included left agraphia, tactile anomia, and auditory suppression. Use of magnetic resonance imaging (MRI) revealed posterior callosal infarction and a right frontal infarct. (PsycINFO Database Copyright 1994 American Psychological Assn, all rights reserved)

KP: posterior callosal & right frontal cerebral infarction; apraxia & behavioral disorders; 44 yr old male; case report

DE: CORPUS-CALLOSUM; BRAIN-DAMAGE; BEHAVIOR-DISORDERS; APRAXIA-; CASE-REPORT; ADULTHOOD-

CC: 3295; 32

PO: Human

AG: Adult

DT: Journal-Article

UD: 9401

AN: 81-02411

PsycINFO 1984-1993 9 of 15

TI: Bilateral alien hand signs following destruction of the medial frontal cortices.

AU: Gasquoine,-Philip-G.

IN: Rehabilitation Hosp of South Texas, Corpus Christi, US

SO: Neuropsychiatry,-Neuropsychology,-and-Behavioral-Neurology; 1993 Jan Vol 6(1) 49-53

IS: 0894878X

LA: English

PY: 1993

AB: Describes a case of bilateral medial frontal cortex destruction, probably due to viral encephalitis, in a 23-yr-old right-handed male. Deficits 5 yrs later included bilateral alien hand signs, transcortical motor aphasia, apraxia, flattened affect, and loss of affective facial expression. These symptoms were attributed to bilateral dysfunction of the supplementary motor areas and associated structures. Dysfunction of the left supplementary motor area was considered responsible for transcortical motor aphasia, apraxia, and the right alien hand sign, while dysfunction of the right supplementary motor area was considered responsible for the loss of affective facial expression and the left alien hand sign. (PsycINFO Database Copyright 1993 American Psychological Assn, all rights reserved)

KP: bilateral alien hand signs; 23 yr old male with bilateral medial frontal cortex destruction; 5 yr followup

DE: FRONTAL-LOBE; BRAIN-DAMAGED; NEUROPSYCHOLOGY-; MOTOR-PROCESSES; FOLLOWUP-STUDIES; ADULTHOOD-

CC: 3297; 32

PO: Human

AG: Adult

DT: Journal-Article

UD: 9306

AN: 80-22358

PsycINFO 1984-1993 10 of 15

TI: The alien hand and related signs.

AU: Doody,-Rachelle-S.; Jankovic,-Joseph

IN: Baylor Coll of Medicine, Houston, TX, US

SO: Journal-of-Neurology,-Neurosurgery-and-Psychiatry; 1992 Sep Vol 55(9) 806-810

IS: 00223050

LA: English

PY: 1992

AB: Describes 7 patients with alien hand sign and other motor or behavioral manifestations (age of onset 57-85 yrs). Etiologies included multiple infarcts and cortobasal ganglionic degeneration (CBD). All Ss had apraxia in response to verbal commands and problems with bimanual coordination. Most displayed nongoal directed involuntary motor activities, and 2 had self-destructive motor behaviors. Grasp reflex occurred with alien hand due to either etiology. Cortical reflex myoclonus was frequently seen in CBD Ss. (PsycINFO Database Copyright 1993 American Psychological Assn, all rights reserved)

KP: assessment & anatomical mechanisms; 57-85 yr olds with neurologically induced alien hand sign & apraxia & bimanual coordination problems

DE: BODY-IMAGE-DISTURBANCES; APRAXIA-; MOTOR-COORDINATION; NEUROLOGY-; AGED-; VERY-OLD; ADULTHOOD-

CC: 3297; 32

PO: Human

AG: Adult; Elderly

DT: Journal-Article

UD: 9304

AN: 80-14293

PsycINFO 1984-1993 11 of 15

TI: Two alien hand syndromes.

AU: Feinberg,-Todd-E.; Schindler,-Rachel-J.; Flanagan,-Natalie-G.; Haber,-Laurence-D.

IN: Beth Israel Medical Ctr, Neurobehavior & Alzheimer's Disease Ctr, New York, NY, US

SO: Neurology; 1992 Jan Vol 42(1) 19-24

IS: 00283878

LA: English

PY: 1992

AB: A review of the clinical characteristics and neuroanatomy of 20 reported cases of alien hand syndrome (AHS) and the case of a 68-yr-old right-handed man indicate that the AHS consists of 2 distinct syndromes. Frontal AHS occurs in the dominant hand; is associated with reflexive grasping, groping, and compulsive manipulation of tools; and results in damage to the supplementary motor area, anterior cingulate gyrus, and medial prefrontal cortex of the dominant hemisphere and anterior corpus callosum. Callosal AHS is characterized by intermanual conflict and requires only an anterior callosal lesion. The occurrence of frontal AHS in the dominant limb can be explained by an increased tendency for dominant limb exploratory reflexes coupled with release from an asymmetrically disturbed, nondominant-hemisphere inhibition. (PsycINFO Database Copyright 1992 American Psychological Assn, all rights reserved)

KP: clinical characteristics & neuropathology; patients with alien hand syndrome

DE: SYNDROMES-; NEUROPATHOLOGY-; HAND-ANATOMY; ADULTHOOD-

CC: 3297; 32

PO: Human

AG: Adult

DT: Journal-Article

UD: 9208

AN: 79-28039

PsycINFO 1984-1993 12 of 15

TI: Right-sided anarchic (alien) hand: A longitudinal study.

AU: della-Sala,-Sergio; Marchetti,-Clelia; Spinnler,-Hans

IN: San Paolo Hosp, Dept of Clinical Neurophysiology, Milan, Italy

SO: Neuropsychologia; 1991 Vol 29(11) 1113-1127

IS: 00283932

LA: English

PY: 1991

AB: Presents the case of a 56-yr-old right-handed female patient with a bilateral frontal vascular lesion encroaching on the mesial cortex on the left and damage of the corpus callosum who showed the alien hand phenomenon on the right. This phenomenon refers to the occurrence of movements of an upper limb that is unintended but directed toward some purpose. The various hypotheses as to the nature of the lesion causing the alien hand phenomenon are discussed. It is proposed that an acute clinical condition, following a lesion of the corpus callosum only, should be differentiated from a chronic condition resulting from the additional fronto-mesial lesion. (PsycINFO Database Copyright 1992 American Psychological Assn, all rights reserved)

KP: right side alien hand phenomenon; right handed female 56 yr old with bilateral frontal vascular lesion encroaching mesial cortex & damage of corpus callosum

DE: HAND-ANATOMY; BRAIN-DAMAGED; FRONTAL-LOBE; CORPUS-CALLOSUM; MOTOR-PROCESSES; CEREBRAL-CORTEX; ADULTHOOD-

CC: 3297; 32

PO: Human

AG: Adult

DT: Journal-Article

UD: 9205

AN: 79-16972

PsycINFO 1984-1993 13 of 15

TI: Alien hand sign and other cognitive deficits following ruptured aneurysm of the anterior communicating artery.

AU: Parkin,-Alan-J.; Barry,-Caroline

IN: U Sussex Lab of Experimental Psychology, Brighton, England

SO: Behavioural-Neurology; 1991 Fal Vol 4(3) 167-179

IS: 09534180

LA: English

PY: 1991

AB: Describes a 46-yr-old right-handed female patient who suffered a ruptured aneurysm of the anterior communicating artery that was clipped successfully. Computerized tomography indicated a low density area in the genu of the corpus callosum and the inferolateral aspect of the left frontal lobe. On admission to rehabilitation, the S exhibited a range of cognitive deficits, the most noticeable of which was the "alien hand sign" (AHS) whereby the left hand would frequently interfere with the actions of the right hand. Problems in response initiation were also evident: There was significant memory loss and performance was impaired on some tests of frontal lobe function. After 14 mo, the AHS had gradually receded but was still manifest to a small degree. Discussion centers on the functional locus of the AHS. (PsycINFO Database Copyright 1992 American Psychological Assn, all rights reserved)

KP: ruptured aneurysm of anterior communicating artery; development of alien hand sign & cognitive deficits; 46 yr old female; case report

DE: ANEURYSMS-; COGNITIVE-ABILITY; MOTOR-PROCESSES; CASE-REPORT; ADULTHOOD-

CC: 3295; 32

PO: Human

AG: Adult

DT: Journal-Article

UD: 9204

AN: 79-13453

PsycINFO 1984-1993 14 of 15

TI: "Alien hand" and loss of bimanual coordination after dominant anterior cerebral artery territory infarction.

AU: McNabb,-A.-W.; Carroll,-W.-M.; Mastaglia,-F.-L.

IN: Queen Elizabeth II Medical Ctr, Dept of Neurology, Nedlands, WAus, Australia

SO: Journal-of-Neurology,-Neurosurgery-and-Psychiatry; 1988 Feb Vol 51(2) 218-222

IS: 00223050

LA: English

PY: 1988

AB: Three adult, right-handed patients with dominant anterior cerebral artery territory infarction demonstrated a severe disturbance of upper limb motor control with impaired bimanual coordination, the "alien hand" sign, and intermanual conflict, in addition to signs of callosal interruption and a transcortical motor aphasia. Recordings of movement-related evoked potentials in one S showed an attenuated Bereitschaftspotential and a greater asymmetry of the NS' component of the premotor negativity with left finger than with right finger movement. The impairment of bimanual motor control and associated abnormal motor behavior of the right hand in these cases is postulated to be due to involvement of the supplementary motor area and related areas of the medial frontal cortex. (PsycINFO Database Copyright 1989 American Psychological Assn, all rights reserved)

KP: impaired upper limb motor control & bimanual coordination & "alien hand" symptoms; female 58-75 yr olds with anterior cerebral artery infarction; case reports

DE: MOTOR-COORDINATION; CEREBROVASCULAR-ACCIDENTS; ARM-ANATOMY; LEG-ANATOMY; HAND-ANATOMY; AGED-; CASE-REPORT; ADULTHOOD-

CC: 3295; 32

PO: Human

AG: Adult; Elderly

DT: Journal-Article

UD: 8902

AN: 76-05724

PsycINFO 1984-1993 15 of 15

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

AU: Levine,-David-N.; Rinn,-William-E.

IN: Massachusetts General Hosp, Behavior Lab, Boston

SO: Neurology; 1986 Aug Vol 36(8) 1094-1097

IS: 00283878

LA: English

PY: 1986

AB: Presents the case of a 79-yr-old right-handed woman who developed left homonymous hemianopia and left hemianesthesia. The S often interpreted spontaneous movements of the left arm as alien in origin. The ataxia may have been caused by a combination of sensory ataxia resulting from right thalamic infarction, and crossed-optic ataxia resulting from posterior disconnection of the hemispheres due to right temporo-occipital infarction. This opticosensory ataxia was associated with a new form of "alien hand" syndrome. (PsycINFO Database Copyright 1987 American Psychological Assn, all rights reserved)

KP: homonymous hemianopia & left hemianesthesia; ataxia & experience of left arm movement as alien in origin; 79 yr old female with right posterior cerebral artery occlusion; case report

DE: HEMIANOPIA-; CEREBROVASCULAR-ACCIDENTS; ATAXIA-; ARM-ANATOMY; ANESTHESIA-FEELING; ADULTHOOD-; CASE-REPORT

CC: 3295; 32

PO: Human

AG: Adult

DT: Journal-Article

UD: 8711

AN: 74-31750


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