Alien hand syndrome

Is it true that alien hand syndrome exists?

Alien hand syndrome is a rare neurological condition that occurs naturally. It is also referred to as the anarchic hand or Dr. Strangelove syndrome. This condition causes one hand (and sometimes a leg) to move involuntarily and independently, without the individual's conscious control or intention. The affected hand may perform actions or movements that the person is not aware of or does not wish to do, resulting in a feeling of the hand having a mind of its own.

Alien hand syndrome is usually caused by damage or lesions in some regions of the brain, such as the corpus callosum, anterior cingulate cortex, posterior parietal cortex, or supplementary motor cortex. It can be associated with various neurological conditions, including strokes, brain tumors, brain injuries, neurodegenerative diseases, and certain brain surgeries.

Can you explain what alien hand syndrome is?

Alien Hand Syndrome is a rare neurological disorder that manifests as one hand acting independently, sometimes affecting a leg, though less common. This condition leads to the affected hand moving seemingly on its own, beyond the individual's control, performing unintentional tasks.

Individuals experience a sense of detachment from the hand during these episodes as if it has a mind of its own. While it can occur in children, Alien Hand Syndrome primarily affects adults and is also known as Dr. Strangelove syndrome, Strangelovian hand, or anarchic hand."

Could this syndrome be fatal?

No, alien hand syndrome itself is not fatal. It is a rare neurological condition that causes one hand (or sometimes a leg) to move involuntarily and seemingly act independently, without the individual's control. While it can be distressing and challenging to manage, it is not directly life-threatening.

Alien Hand: Understanding its Causes and Brain Mechanisms :

Alien hand syndrome can arise from various factors, including strokes, trauma, tumors, cancer, neurodegenerative diseases, and brain aneurysms. It is often associated with surgeries that involve separating the brain's two hemispheres, such as surgeries to treat epilepsy, which may impact the corpus callosum responsible for inter-hemispheric communication.

Individuals with alien hand syndrome show isolated activity in the contralateral primary motor area on brain scans, which is caused by damage or lesions in the parietal cortex. This can impact the planning system and result in involuntary movements of the affected hand. Moreover, individuals with this condition also have lesions in the anterior cingulate cortex, posterior parietal cortex, and supplementary motor cortex areas of the brain.

Symptoms of Alien Hand:

Alien hand syndrome is characterized by the lack of control over one hand, as it seems to act independently, almost as if it has a mind of its own. This condition can lead to involuntary movements and goal-directed actions without the person's cognitive awareness or control. For instance, the alien hand may perform tasks like touching one's face, buttoning a shirt, or picking up objects repetitively or compulsively.

In some cases, the alien hand may even levitate on its own, engaging in self-oppositional actions, like closing a drawer just opened by the other hand or unbuttoning a shirt that was just buttoned. This uncooperative behavior may include incorrect actions or failure to follow commands.

Although individuals with alien hand syndrome may sense that the affected hand or limb feels foreign or disconnected from them, they still acknowledge the ownership of the stem, which distinguishes this condition from other disorders. Understanding the symptoms and nature of alien hand syndrome is essential for those who may be experiencing this rare neurological condition.

How Diagnosing This Syndrome:

Diagnosing alien hand syndrome can be challenging for doctors due to its purely neurological nature without a psychiatric component. Unlike behavioral issues, which are more common, this rare condition lacks obvious psychological factors, making it more elusive to diagnose. The diagnostic process involves carefully observing and evaluating the patient's symptoms and behaviors.

However, because some symptoms may overlap with those of psychiatric disorders, individuals affected by alien hand syndrome may experience frustration in seeking an accurate diagnosis. A comprehensive understanding of the condition and its distinct characteristics is essential for medical professionals to accurately identify and manage alien hand syndrome cases.

Treatment :

At present, there is no known cure for alien hand syndrome. However, researchers are actively working on developing treatments to ease its symptoms. Although therapies and pharmacologic options are still in the early stages of development, muscle control therapies such as botulinum toxin (Botox) and neuromuscular blocking agents have shown potential in managing the condition. In some instances, benzodiazepines have proven effective, but behavioral techniques appear to be more advantageous overall.

Mirror box therapy, cognitive therapy techniques, and learning task behavioral therapies have proven helpful in managing symptoms. Visuospatial coaching techniques may also be effective. Some individuals try to restrain their alien hand by holding it between their legs or sitting on it, while others find that holding an object in the alien hand can prevent unintended actions.

Verbal commands to stop the hand's movements can be useful, but their effectiveness may vary from person to person and may not provide long-lasting results. Physical and occupational therapies may be recommended by doctors to aid in managing the condition.

While full recovery is more likely for those who develop alien hand syndrome after brain illness or a stroke, individuals with neurodegenerative diseases may find it more challenging to achieve significant improvement. As research continues, new treatment approaches may offer hope for better symptom management and improved quality of life for those affected by this rare neurological condition.

Possible Cardioembolic Stroke Case

This case study highlights the unusual presentation of a 77-year-old woman with chronic atrial fibrillation who experienced a stroke after her anticoagulation was temporarily halted for spine surgery. The sudden onset of uncontrolled left-hand movements, subsequent weakness, and numbness led to the discovery of acute infarcts in both parietal lobes.

Case Description:

Following spinal surgery, the patient's anticoagulation treatment ceased without bridging. Two days later, she suffered a frightening incident where her left hand moved involuntarily across her visual field, carrying out purposeful movements. She was unable to control her left hand for almost half an hour and also reported feeling numbness and mild weakness in her left upper limb. Her left leg also showed weakness as she dragged it while walking. A CT scan and MRI of the brain revealed acute infarcts in both parietal lobes, while echocardiograms showed no evidence of thrombus.

Diagnosis and Treatment:

The individual was diagnosed with a stroke, potentially caused by cardioembolism. Their anticoagulation treatment was restarted, and within the next 6 hours, they gradually recovered normal control of their left side. After the incident, they were advised to continue their anticoagulation treatment at all times to decrease the possibility of future embolic events.