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Ma Y, Liu Y, Yan X, Ouyang Y. Alien hand syndrome, a rare presentation of corpus callosum and cingulate infarction. J Neurol Sci 2023; 452:120739. [PMID: 37536055 DOI: 10.1016/j.jns.2023.120739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/09/2023] [Accepted: 07/23/2023] [Indexed: 08/05/2023]
Abstract
Alien hand syndrome (AHS) is a rare apraxia syndrome, characterized by involuntary and uncontrollable movements of one upper limb, often accompanied by intermanual conflict. Damage to the corpus callosum, acute infarction and neurodegenerative disease may result in AHS. Based on the presentation and impairment region, AHS has three variants: frontal, callosal and posterior. Each type may have a different clinical presentation. A total of 157 patients admitted to hospital with corpus callosum infarction between 2012 and 2022 were included for this study, of whom a number of 5 presented with AHS. 4 of them had significant symptoms of intermanual conflict and 1 had strong grip symptoms in the affected upper limb. Moreover, new infarcts involving the corpus callosum and cingulate gyrus were found on MRI in all five patients. We simultaneously performed a retrospective study on all reported AHS cases caused by infarction of the corpus callosum. Case reports and literature reviews were conducted in order to provide clinicians with a better understanding of AHS, its etiology, clinical presentation, diagnosis, and treatment.
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Affiliation(s)
- Yiming Ma
- Department of Neurology, The First Hospital of China Medical University, Shenyang City, Liaoning Province, China
| | - Ye Liu
- Department of Neurology, The First Hospital of China Medical University, Shenyang City, Liaoning Province, China
| | - Xuejing Yan
- Department of Neurology, The First Hospital of China Medical University, Shenyang City, Liaoning Province, China
| | - Yi Ouyang
- Department of Neurology, The First Hospital of China Medical University, Shenyang City, Liaoning Province, China.
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Sugawara K, Takeuchi T, Harada K, Taki M, Fujimura I, Kogami Y, Furuta R. Case report: Self-restraint in a patient with alien hand syndrome following cerebral infarction involving the anterior cerebral artery territory. Front Neurol 2023; 14:1203450. [PMID: 37521292 PMCID: PMC10375235 DOI: 10.3389/fneur.2023.1203450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023] Open
Abstract
Frontal alien hand syndrome (AHS) presents as impulsive grasping and groping and compulsive manipulation of environmental objects that can affect the dominant or nondominant hand. A few reports have shown improvements in neuropsychological scores over time when self-restraint of the right hand AHS was enforced. A 72-year-old woman presented with right-handed involuntary instinctive grasping reactions and compulsive manipulation of tools after an infarction of the frontal lobe and corpus callosum (CC). She was diagnosed with cerebral infarction involving the anterior cerebral artery territory and a frontal variant of AHS. At AHS onset, the patient was unaware that her right hand was moving against her will; she was only aware that her right hand was moving when the therapist pointed it out to her. Later, she began to recognize that her right hand was involuntarily moving, and she could restrain the movement of her right hand with her left hand. Approximately 5 months following AHS onset, the patient could voluntarily restrain her AHS symptoms by telling her right hand not to move against her will in her head. Most neuropsychological scores improved by 5 months following AHS onset. However, the patient showed disruptions in the genu and midbody of the left cingulate cortex, as shown via diffusion tensor imaging (DTI), and the sensation of the "right hand moving by itself" remained even 5 months after AHS onset. Although damage to the CC fibers was evident on DTI at 5 months following onset, the patient exhibited no sensory deficits and demonstrated good hand ownership as well as early improvement in attention and cognitive dysfunction. Therefore, the patient recognized her AHS symptoms, which included her hand moving against her will, and was able to consciously restrain her hand movement.
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Affiliation(s)
- Kazuhiro Sugawara
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Toshiki Takeuchi
- Department of Rehabilitation, Kashiwaba Neurosurgical Hospital, Sapporo, Japan
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Kuniaki Harada
- Department of Radiological Sciences, Faculty of Health Sciences, Japan Healthcare University, Sapporo, Japan
| | - Marina Taki
- Department of Rehabilitation, Kashiwaba Neurosurgical Hospital, Sapporo, Japan
| | - Ikumi Fujimura
- Department of Rehabilitation, Kashiwaba Neurosurgical Hospital, Sapporo, Japan
| | - Yuichi Kogami
- Department of Rehabilitation, Kashiwaba Neurosurgical Hospital, Sapporo, Japan
| | - Ryoichi Furuta
- Department of Rehabilitation, Kashiwaba Neurosurgical Hospital, Sapporo, Japan
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Sarkar P, Ray BK, Mukherjee D, Pandit A, Ghosh R, Benito-León J, Dubey S. Alien Limb Phenomenon After Diffuse Corpus Callosum Ischemic Stroke. Neurohospitalist 2022; 12:295-300. [PMID: 35419142 PMCID: PMC8995589 DOI: 10.1177/19418744211067033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The alien limb is a phenomenon characterized by a cluster of clinical features wherein the limb behaves autonomously and as separated from a person's identity. We herein report a 36-year-old Indian female with multiple comorbidities who presented with recurrent episodes of limb-shaking transient ischemic attacks for 1 year, followed by left-sided hemiplegia. During recovering, the patient noticed a feeling that as if her left hand did not belong to herself and acted autonomously (alien limb phenomenon) along with visuospatial deficits. Magnetic resonance imaging of the brain revealed ischemic stroke diffusely involving corpus callosum. Magnetic resonance angiography was suggestive of compromised right-sided anterior circulation. This was corroborated by digital subtraction angiography that revealed reduced flow in right internal carotid artery. Diffuse infarction of the corpus callosum requires involvement of both the anterior and the posterior circulation. Due to the lack of clinical features suggestive of chronic internal carotid artery dissection, occlusive atherosclerotic disease of the anterior cerebral circulation associated with possible steal phenomenon from the posterior circulation was the most probable underlying mechanism for the callosal stroke. Steal phenomenon has been proposed as a compensatory mechanism in hemodynamically compromised ischemic parenchyma and it can explain the co-existence of anterior and posterior circulation strokes. This case also highlights how both anterior and posterior types of the alien limb phenomenon can co-exist in a background of vascular insult, resulting from intra-cranial atherosclerotic disease.
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Affiliation(s)
- Peyalee Sarkar
- Department of Neuromedicine, Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education and Research & SSKM Hospital, Kolkata, West Bengal,
India
| | - Biman Kanti Ray
- Department of Neuromedicine, Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education and Research & SSKM Hospital, Kolkata, West Bengal,
India
| | - Debaleena Mukherjee
- Department of Neuromedicine, Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education and Research & SSKM Hospital, Kolkata, West Bengal,
India
| | - Alak Pandit
- Department of Neuromedicine, Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education and Research & SSKM Hospital, Kolkata, West Bengal,
India
| | - Ritwik Ghosh
- Department of General Medicine, Burdwan Medical College and
Hospital, Burdwan, West Bengal, India
| | - Julián Benito-León
- Department of Neurology, University Hospital “12 de
Octubre”, Madrid, Spain
- Centro de Investigación Biomédica en
Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Department of Medicine, Complutense University, Madrid, Spain
| | - Souvik Dubey
- Department of Neuromedicine, Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education and Research & SSKM Hospital, Kolkata, West Bengal,
India
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Pradhan A, Reddy AJ, Rajendran A, Nawathey N, Bachir M, Brahmbhatt H. An Investigation on the Preconditions and Diagnosis Methods for Alien Hand Syndrome. Cureus 2022; 14:e22381. [PMID: 35371673 PMCID: PMC8938234 DOI: 10.7759/cureus.22381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2022] [Indexed: 11/05/2022] Open
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Qu K, Gan L, Jiang W, Yu P, Dong M. Case Report: Good Prognosis of Mixed Alien Hand Syndrome by Verbal-Cue Rehabilitation Exercise. Front Neurol 2021; 12:718706. [PMID: 34566861 PMCID: PMC8455835 DOI: 10.3389/fneur.2021.718706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
Mixed alien hand syndrome is a rare disease reported in the literature. The mixed callosal–frontal variant of alien hand syndrome is associated with uncoordinated hand movements, and patients may present with an involuntary grasp reflex and intermanual conflict. There are few videos in the existing literature on the comparison of patients' condition before and after recovery of the symptoms of mixed alien hand syndrome. We presented the prognosis of mixed alien hand syndrome in the form of a video. In addition, we have included some videos on the comparison of the condition of patients before and after recovery of the symptoms of mixed alien hand syndrome. A 57-year-old woman presented with left-handed intermanual conflict and right-handed involuntary grasp reflex due to infarction of the frontal lobe and corpus callosum. She was diagnosed with a mixed callosal–frontal variant of alien hand syndrome. Her left hand counteracted the purposeful movements of the right hand. However, the intermanual conflict disappeared after 3 months of therapy, including drug treatment and verbal-cue rehabilitation, and she regained normal coordination of her hand movements. Her prognosis was good despite the large corpus callosum lesions. The uncoordinated hand movements of the patient affected her daily life and caused psychological problems. Initiating rehabilitation early was important and necessary for her to regain coordination. It is possible that the verbal-cue training method played an important role in the recovery of the patient. Therefore, this method of rehabilitation deserves consideration and can be adopted in larger cohort studies as we presented only a single case. The possible mechanisms behind the verbal-cue exercise require further studies, and this patient had a good prognosis despite severe corpus callosum injury, which may merit further investigation.
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Affiliation(s)
- Kang Qu
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Lin Gan
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Wei Jiang
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Peng Yu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Ming Dong
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
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Bouvy C, Ackermans N, Maldonado Slootjes S, Rutgers MP, Gille M. Reversible cerebral vasoconstriction syndrome revealed by fronto-callosal infarctions. Acta Neurol Belg 2020; 120:1467-1469. [PMID: 32157672 DOI: 10.1007/s13760-020-01319-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/27/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Céline Bouvy
- Department of Neurology, Europe Hospitals, 206 Avenue de Fré, 1180, Brussels, Belgium
| | - Nathalie Ackermans
- Department of Neurology, Europe Hospitals, 206 Avenue de Fré, 1180, Brussels, Belgium
| | | | | | - Michel Gille
- Department of Neurology, Europe Hospitals, 206 Avenue de Fré, 1180, Brussels, Belgium.
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Abstract
The development and persistence of laterality is a key feature of human motor behavior, with the asymmetry of hand use being the most prominent. The idea that asymmetrical functions of the hands reflect asymmetries in terms of structural and functional brain organization has been tested many times. However, despite advances in laterality research and increased understanding of this population-level bias, the neural basis of handedness remains elusive. Recent developments in diffusion magnetic resonance imaging enabled the exploration of lateralized motor behavior also in terms of white matter and connectional neuroanatomy. Despite incomplete and partly inconsistent evidence, structural connectivity of both intrahemispheric and interhemispheric white matter seems to differ between left and right-handers. Handedness was related to asymmetry of intrahemispheric pathways important for visuomotor and visuospatial processing (superior longitudinal fasciculus), but not to projection tracts supporting motor execution (corticospinal tract). Moreover, the interindividual variability of the main commissural pathway corpus callosum seems to be associated with handedness. The review highlights the importance of exploring new avenues for the study of handedness and presents the latest state of knowledge that can be used to guide future neuroscientific and genetic research.
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Affiliation(s)
- Sanja Budisavljevic
- Department of General Psychology, University of Padova, Padova, Italy.,The School of Medicine, University of St. Andrews, St. Andrews, UK
| | - Umberto Castiello
- Department of General Psychology, University of Padova, Padova, Italy
| | - Chiara Begliomini
- Department of General Psychology, University of Padova, Padova, Italy
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Cirnigliaro G, Di Bernardo I, Caricasole V, Piccoli E, Scaramelli B, Pomati S, Villa C, Pantoni L, Dell'Osso B. Treatment-related transient splenial lesion of the Corpus Callosum in patients with neuropsychiatric disorders: a literature overview with a case report. Expert Opin Drug Saf 2020; 19:315-325. [PMID: 32063066 DOI: 10.1080/14740338.2020.1731472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Transient-localized lesions of the splenium of the corpus callosum (SCC) have been described in various clinical conditions, some of them being attributed to the withdrawal of psychotropic drugs. The pathophysiology of the lesion reflects cytotoxic edema and reversible demyelination.Areas covered: The present article aimed at reviewing cases of transient SCC lesion exclusively related to changes in pharmacotherapy. It also reports the original case of a patient receiving a complex psychopharmacological therapy who developed a transient SCC lesion investigated by magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and pharmacogenetic profiling.Expert opinion: To date, only one review on the subject has been published, analyzing 22 cases of transient SCC lesion arising in epileptic patients on antiepileptic therapy. It hypothesized that the nature of the lesion is a cytotoxic edema and the cases described in the subsequent 14 years seem to support this hypothesis. The authors reported the case of an Italian-Egyptian patient who developed a transient SCC lesion after the rapid withdrawal of Carbamazepine and Lurasidone. The lesion completely disappeared from the MRI performed after 1 month. Patient's ethnic group and its pharmacogenetic profile were considered as possible causes of altered drug metabolism and, likely, of the SCC lesion.
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Affiliation(s)
- Giovanna Cirnigliaro
- Department of Mental Health, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - Ilaria Di Bernardo
- Department of Mental Health, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - Valentina Caricasole
- Department of Mental Health, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - Eleonora Piccoli
- Department of Mental Health, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - Barbara Scaramelli
- Department of Mental Health, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - Simone Pomati
- Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, Neurology Unit, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - Chiara Villa
- Department of Radiology, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Leonardo Pantoni
- Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, Neurology Unit, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy.,Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche, University of Milan, Milan, Italy
| | - Bernardo Dell'Osso
- Department of Mental Health, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy.,Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, CA, USA.,Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche, University of Milan, Milan, Italy.,"Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
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Clinical Features, Etiology, and 6-Month Prognosis of Isolated Corpus Callosum Infarction. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9458039. [PMID: 31218228 PMCID: PMC6537009 DOI: 10.1155/2019/9458039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/30/2019] [Indexed: 12/18/2022]
Abstract
As the largest subcortical commissural fiber, the corpus callosum plays an important role in cerebral functions and has abundant blood supply from bilateral circulation. Isolated corpus callosum infarction (ICCI) may have specific characteristics. The aim of the study is to evaluate the clinical features, etiology, and 6-month prognosis of ICCI. Consecutive patients with acute ICCI treated at the China-Japan Friendship Hospital between June 2012 and June 2016 were retrospectively assessed for clinical and imaging findings. These cases were compared with patients suffering from other isolated supratentorial subcortical infarctions, matched for age, sex, and infarction size (n=60; control group). ICCI etiology and 6-month prognosis were further analyzed. ICCI cases accounted for 2.9% (33/1125) of all acute ischemic strokes and 30 patients were included. Most patients (n=28, 93.3%) presented nonspecific clinical symptoms, and only two (6.7%) with diffuse infarction developed callosal disconnection syndrome (CDS). The splenium was the most frequent site (37.5%). Large artery atherosclerosis (LAA) (n=16, 53.3%) was the most common etiology. Only four (13.3%) patients developed transient ischemic attacks (n=1, 3.3%) or cerebral infarction (n=3, 10%) during the 6-month follow-up. The frequency of good prognosis (modified Rankin score of 1-2 and without cardiovascular events) was higher in patients with ICCI compared with controls (P=0.024). Poor prognosis was associated with multiple cerebrovascular stenosis, diffuse/large infarction, and diabetes (all P<0.05). ICCI is a rare stroke type, frequently involving the splenium; its common etiology is likely LAA. Most patients show nonspecific symptoms, with only a few developing CDS. ICCI generally shows favorable short-term outcome.
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Sun X, Li J, Fan C, Zhang H, Si Y, Fang X, Guo Y, Zhang JH, Wu T, Ding S, Bi X. Clinical, neuroimaging and prognostic study of 127 cases with infarction of the corpus callosum. Eur J Neurol 2019; 26:1075-1081. [PMID: 30793437 PMCID: PMC6767551 DOI: 10.1111/ene.13942] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 02/19/2019] [Indexed: 11/26/2022]
Abstract
Background and purpose The aim of this study was to retrospectively investigate clinical and neuroimaging characteristics in the largest sample size of patients with corpus callosum infarction to date and then to follow up these patients for 1 year to clarify the prognosis of this rare stroke entity. Methods A total of 127 patients with acute callosal infarction out of 5584 acute ischaemic stroke patients were included in this study. The recruited patients were divided into a pure callosal infarction group and a complex callosal infarction group (coupled with other infarct locations simultaneously), and clinical and neuroimaging features were analyzed. Some of the patients were followed up for 1 year to evaluate recurrence rate and mortality. Results The incidence of acute callosal infarction was 2.3%. Most patients presented with advanced neurological dysfunction with or without mild to moderate motor or sensory disorders on admission. The negative rate of computed tomography scan was still 76.4% even at >24 h after onset. Large‐artery atherosclerosis was the most common etiological type. Compared with complex callosal infarction, the pure callosal infarction group had more mental disorders (P = 0.030). Compared with common basal ganglia infarction, the pure callosal infarction group had better short‐term recovery (P = 0.016) but higher 1‐year mortality (P = 0.037). Age and mental disorders were independent risk factors for death in callosal infarction. Conclusions Callosal infarction is a white matter stroke that occurs with low incidence. Elderly patients with vascular risk factors showed sudden mental or cognitive disorders and callosal infarction could not be excluded. More attention should be paid to the early diagnosis and secondary prevention of callosal infarction because of its poor long‐term outcome.
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Affiliation(s)
- X Sun
- Department of Neurology, Changhai Hospital, Shanghai
| | - J Li
- Department of Neurology, Changhai Hospital, Shanghai
| | - C Fan
- Department of Neurology, Changhai Hospital, Shanghai
| | - H Zhang
- Department of Neurology, Changhai Hospital, Shanghai
| | - Y Si
- Department of Transfusion Medicine, Xinhua Hospital Affiliated to Shanghai JiaoTong University, Shanghai
| | - X Fang
- Department of Radiology, Changhai Hospital, Shanghai
| | - Y Guo
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - J H Zhang
- Department of Neurosurgery, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - T Wu
- Department of Neurology, Changhai Hospital, Shanghai
| | - S Ding
- Department of Neurology, Changhai Hospital, Shanghai
| | - X Bi
- Department of Neurology, Changhai Hospital, Shanghai
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Gellman SR, Ng YT. Transient Corpus Callosal Lesion Presenting with Alien Hand Syndrome. Pediatr Neurol 2018; 89:66-67. [PMID: 30389110 DOI: 10.1016/j.pediatrneurol.2018.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/06/2018] [Accepted: 08/11/2018] [Indexed: 10/28/2022]
Affiliation(s)
- S Rosie Gellman
- Department of Pediatrics, Baylor College of Medicine, The Children's Hospital of San Antonio, San Antonio, Texas
| | - Yu-Tze Ng
- Department of Pediatrics, Baylor College of Medicine, The Children's Hospital of San Antonio, San Antonio, Texas.
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Vasconcelos Calheiros de Oliveira Costa G, Lazaretto Padua MH, Ouriques Martins SC, Avila Duarte J, Brondani R, Garcia de Almeida A. Teaching NeuroImages: Complex bilateral corpus callosum infarction after paradoxical embolism: Lightning strikes twice. Neurology 2018; 91:e1947-e1948. [PMID: 30420465 DOI: 10.1212/wnl.0000000000006505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- George Vasconcelos Calheiros de Oliveira Costa
- From the Departments of Neurology (G.V.C.d.O.C., M.H.L.P., S.C.O.M., R.B., A.G.d.A.), Internal Medicine (S.C.O.M.), and Radiology (J.A.D.), Hospital de Clínicas de Porto Alegre, Brazil.
| | - Mario Henrique Lazaretto Padua
- From the Departments of Neurology (G.V.C.d.O.C., M.H.L.P., S.C.O.M., R.B., A.G.d.A.), Internal Medicine (S.C.O.M.), and Radiology (J.A.D.), Hospital de Clínicas de Porto Alegre, Brazil
| | - Sheila Cristina Ouriques Martins
- From the Departments of Neurology (G.V.C.d.O.C., M.H.L.P., S.C.O.M., R.B., A.G.d.A.), Internal Medicine (S.C.O.M.), and Radiology (J.A.D.), Hospital de Clínicas de Porto Alegre, Brazil
| | - Juliana Avila Duarte
- From the Departments of Neurology (G.V.C.d.O.C., M.H.L.P., S.C.O.M., R.B., A.G.d.A.), Internal Medicine (S.C.O.M.), and Radiology (J.A.D.), Hospital de Clínicas de Porto Alegre, Brazil
| | - Rosane Brondani
- From the Departments of Neurology (G.V.C.d.O.C., M.H.L.P., S.C.O.M., R.B., A.G.d.A.), Internal Medicine (S.C.O.M.), and Radiology (J.A.D.), Hospital de Clínicas de Porto Alegre, Brazil
| | - Andrea Garcia de Almeida
- From the Departments of Neurology (G.V.C.d.O.C., M.H.L.P., S.C.O.M., R.B., A.G.d.A.), Internal Medicine (S.C.O.M.), and Radiology (J.A.D.), Hospital de Clínicas de Porto Alegre, Brazil
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13
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Conflict sign between an automatic and a controlled action and its process of improvement after damage to the left medial prefrontal cortex. Neurol Sci 2018; 39:1991-1992. [PMID: 30032333 DOI: 10.1007/s10072-018-3508-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/18/2018] [Indexed: 10/28/2022]
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Erdal Y, Emre U, Cimen Atalar A, Gunes T. Alien hand syndrome and migraine with aura: A case report. Cephalalgia 2018; 38:1984-1987. [PMID: 29504481 DOI: 10.1177/0333102418763321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Alien Hand Syndrome (AHS) is an uncontrollable, involuntary, but in appearance, purposeful motor control disorder of the upper extremity. CASE REPORT A 42-year-old male patient was admitted to our clinic complaining of involuntary motor activity in his right hand. He had a previous history of migraine with visual aura. The uncontrollable motor control disorder was compatible with Alien Hand Syndrome, which was appearing immediately after the visual aura and before the beginning of headache. CONCLUSION Alien Hand Syndrome is usually observed with anterior cerebral artery infarction, midline tumors, trauma and several neurodegenerative diseases, but is rarely seen in paroxysmal conditions such as migraine with aura.
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Affiliation(s)
- Yuksel Erdal
- 1 Health Sciences University Istanbul Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Ufuk Emre
- 1 Health Sciences University Istanbul Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Arife Cimen Atalar
- 1 Health Sciences University Istanbul Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Taskın Gunes
- 2 Istanbul Bahcelievler State Hospital, Department of Neurology, Istanbul, Turkey
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