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February 14, 2017 E-Pearl of the Week: Alien limb phenomenon

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Brought to you by the Residents & Fellows Section of Neurology®.

January 30, 2017

Alien limb phenomenon

Alien limb phenomenon, where patients exhibit involuntary limb movements and estrangement from the affected limb, although three variants have been described. The frontal variant, which commonly affects the dominant hand, features involuntary groping or grasping behaviors and object manipulation. The callosal variant often manifests as intermanual conflict. The posterior variant, most commonly associated with corticobasal syndrome2 and affecting the non-dominant limb. The right parietal lobe is primarily affected1, 2. Multiple etiologies of alien limb phenomenon exist, including ischemic infarcts1, 2. Multiple theories on the underlying mechanisms have been speculated but a definitive answer has not been reached1

  References:

  1. Hassan A, Josephs KA. Alien Hand Syndrome. Curr Neurol Neurosci Rep 2016; 16: 73.
  2. Graff-Radford J, Rubin MN, Jones DT, et al. The alien limb phenomenon. J Neurol 2013; 260: 1880-1888.

 Submitted by Ilena George, MD - Department of Neurology, Yale School of Medicine, New Haven. Dr. George is a member of the Resident and Fellow Section of Neurology.


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