Sepideh Pooyania1, Sharon Mohr, Sherie Gray. 1. Department of Physical Medicine and Rehabilitation, University of Manitoba, Riverview Health Center, Winnipeg, Canada. sepidehali@yahoo.com
Abstract
BACKGROUND: Alien hand syndrome (AHS) is a neurological disorder in which movements are performed against conscious will. It is rare but significant due to its disability impact on everyday life. This case highlights the clinical features, recovery course and response to rehabilitation of a patient with a dominant anterior cerebral artery territory infarct. METHODS: Single case report. RESULTS: Clinical signs and symptoms included right hemiparesis, hemianesthesia, dysphagia, language and cognitive dysfunction, personification and autonomous movement of the affected limb; involuntary grasping of objects interfered with his activities of daily living (ADL). Education for diagnosis and compensatory strategies of AHS, including visualisation, distraction of affected limb and maintaining a slow/steady pace with activities decreased the frequency of his AHS movements from 10 times to twice a day. Over the course of 4 months the rehabilitation treatment targeted toward the specific needs of the patient, allowed improvement in his ADL. Commonly used upper extremity motor recovery outcome measures like the Chedoke McMaster Stroke Assessment cannot be considered as a sensitive tool for AHS. More sensitive outcome measures are needed to be determined for this condition. CONCLUSION: This case distinguishes the clinical findings and description to rehabilitation in a case of AHS.
BACKGROUND:Alienhand syndrome (AHS) is a neurological disorder in which movements are performed against conscious will. It is rare but significant due to its disability impact on everyday life. This case highlights the clinical features, recovery course and response to rehabilitation of a patient with a dominant anterior cerebral artery territory infarct. METHODS: Single case report. RESULTS: Clinical signs and symptoms included right hemiparesis, hemianesthesia, dysphagia, language and cognitive dysfunction, personification and autonomous movement of the affected limb; involuntary grasping of objects interfered with his activities of daily living (ADL). Education for diagnosis and compensatory strategies of AHS, including visualisation, distraction of affected limb and maintaining a slow/steady pace with activities decreased the frequency of his AHS movements from 10 times to twice a day. Over the course of 4 months the rehabilitation treatment targeted toward the specific needs of the patient, allowed improvement in his ADL. Commonly used upper extremity motor recovery outcome measures like the Chedoke McMaster Stroke Assessment cannot be considered as a sensitive tool for AHS. More sensitive outcome measures are needed to be determined for this condition. CONCLUSION: This case distinguishes the clinical findings and description to rehabilitation in a case of AHS.