Alien hand syndrome



ALIEN HAND SYNDROME (AHS): How lives get disrupted with unwanted movements….

A rare neurological disorder where a complete loss of control of one limb occurs, most often the left hand, and the hand moves and does actions on its own at a random pace and acts as an alien to the affected individual.

What is Alien hand syndrome?

A fascinating disorder of movement wherein you notice that one of your limbs acts as an alien and performs activities and movements without your intention, control and guidance. Most often you experience the feeling as if someone else intentionally moves the alien hand
and performs actions. Most individuals affected with Alien hand syndrome often say that the alien hand or alien limb is in the third person and is not their own.

Dr. Strangelove, the character of Stanley Kubrick’s movie shows a bizarre movement disorder. His right arm performs actions by its own will very much similar to that of alien hand syndrome. Dr. Stangelove tries to restrain this alien limb with his left hand. Hence, Alien hand syndrome is also known as Dr. Strangelove syndrome.

The frequency rate of AHS among individuals….

Alien Hand syndrome most often affects adults, both men, and women. Few children are also affected with this syndrome.

Causes of Alien hand syndrome

The strange disorder can result from brain damage as an aftereffect of surgery, brain tumors, stroke, trauma to the brain, neurodegenerative diseases ( Alzheimer’s disease, dementia), Aneurysms, multiple sclerosis, diverse cerebral illnesses. Migraine, cancer, and infection in some people were also the reason for developing this Alien Hand Syndrome.

The region of the brain called the primary motor cortex area is responsible for coordinating and controlling the movements of muscles in the hands and legs. When this controlling center becomes faulty, another set of parallel nerves try to help in performing its friend nerves
duties. As a result, everything becomes haphazard and an alien hand syndrome develops. However, there is an unknown hidden factor.

Brain surgeries that separate the left and right hemispheres of the brain have an association with the development of Alien hand syndrome. During this surgery, an incision along the corpus callosum is done. The Corpus callosum is the portion that divides the left and right
hemispheres of the brain into two hemispheres and is a communication channel between these two sides. Hence, a surgical repair in the corpus callosum can result in a movement disorder called Alien hand syndrome.

However, an unknown factor plays a hidden role in the development of this strange disorder.

Which are the areas affected by alien hand syndrome?

Alien hand syndrome most of the time affects the left or non-dominant hand. In some reported cases leg were affected but is rarest.

Types of AHS

AHS is divided into three types based on the areas of brain impairment

Types of AHS

  • The frontal type occurs after injury or impairment of motor area, corpus callosum of the brain.
  • The callosal type occurs after injury or impairment of the callosal area of the brain.
  • The posterior variant is seen if injury or impairment occurs in the thalamic, occipital, and parietal regions of the brain.

Let us now look into the signs and symptoms of this rare syndrome?

The chief complaint you make is that you are unable to control your hand and it acts freely on its own without your intention. The affected hand moves involuntarily and performs various tasks and actions by itself.

The hand moves without your awareness and may touch surfaces or pick an object. Repeated actions are also common. You often have a thought that someone else is doing the activities as it is uncooperative most of the time. The hand indulges in opposing actions such as
opening the door that the other hand has just closed or unbuttoning the shirt that you have just buttoned.

An African- American 84-year-old woman with AHS had uncontrollable left-hand movements and it was trying to grab herself on her body. She explained that while asleep she felt as if someone is trying to grab her and she doubted the presence of someone in the room. She was disturbed by this hand while eating, watching TV, etc.

A 65- year old professional pianist expressed that her arm didn’t do what it was supposed to and stopped playing as things going awkward. Her right hand raised involuntarily when she moved her left hand. She felt strange and was shocked by this behavior of her arm.

Hence, I think now you got more idea about the symptoms of Alien hand syndrome. You will find yourself reaching for objects, moving things, you sometimes use your other hand to restrain the actions of the other. Some people even pinch and hit themselves against their
wishes and will. Even though not so common Alien limb syndrome can also cause legs to move on their own.

How to diagnose Alien hand syndrome?

For diagnosing alien hand syndrome is a real challenge. It is a neurological disorder with signs and symptoms similar to those of some psychiatric disorders. The psychiatric part is not present in this syndrome and your doctor has to identify this fact. Behavioral problems are
more commonly seen in people with Alien hand syndrome. Hence looking into the symptoms it is quite common for your doctor to conclude that you have some sort of psychiatric behavioral problem. You will then feel stressed and frustrated.

  • History collection and physical examination is the initial assessment from the side of your doctor.
  • Systemic examination and an in-detailed neurological examination is performed by your physician with more focus on gait, coordination, and cerebellar function test.
  • The mental status examination may also be conducted to rule out the psychiatric component and make sure that this is a neurological disorder.
  • Observation and evaluating your problem can help your doctor to diagnose your condition.
  • CT scans and MRI of the brain would help assess any impairment or damage to certain specific areas in the brain that plays an important role in the movement.
  • Stroke and brain tumors can also be ruled out with appropriate imaging techniques

What are the ways to manage Alien Hand Syndrome?

  • Cure to this rare neurological disorder is not there. However, symptomatic treatment and management can be helpful for you to anage the disorder. Scientists are working on various treatment modalities and are in research processes for a better outcome.
  • Those who had alien hand syndrome as a result of illness of brain or after effect of the stroke has recovery chances after some time. People with this syndrome due to underlying neurodegenerative disorder has fewer recovery chances.
  • Muscle control therapy and use of neuromuscular blocking agents for example botulinum toxin (Botox) are used for alien hand syndrome treatment and management. Clonazepam is also used as a treatment choice.
  • Coping strategies are very effective for individuals to cope up with this neurological disorder and lead a life. Let us discuss some ….
  •  Cognitive-behavioral therapies, task learning behaviors, mirror box therapy can help in managing alien hand syndrome.
  • Keeping the alien hand engaged by giving it some task is very helpful. For example, if you give your alien hand an object to hold or grasp. A person with alien hand syndrome who had the behavior to hold different objects while walking was given a cane in the alien hand to hold while walking.
  • Another method is to train the affected individual to perform a specific activity or task, for instance moving the alien hand to touch some object or anything, which is a learned movement carried out voluntarily by the individual thus you can override the behavior of your alien hand. It requires appropriate training and guidance.
  •  Mirror box therapy, which is a rehabilitative tool is used for some people. The reflection of the intact hand is seen in the mirror and the alien hand is kept hidden. Hence, the altered body representation can be improved by visual senses, and positiveness is generated in you.
  • Some people try to restrain their alien hand by holding it between thighs or sitting on it to prevent unwanted activities and movements.
  • Your doctor may sometimes advise going for physiotherapy and occupational therapies.

Hence, a proper diagnosis and managing the symptoms using various therapies can make your life easy with alien hand syndrome. Based upon your needs your doctor will schedule a plan of treatment for you to enhance your life quality.

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