Wu F Y, Leong C P, Su T L
Department of Rehabilitation, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1999 Dec;22(4):660-5.
Alien hand syndrome (AHS) refers to the occurrence of apparently purposeful movements in the hand which are independent of volitional control. Two subtypes of AHS have been proposed: frontal AHS, with grasp reflex and compulsive manipulation of tools by the dominant hand, and callosal AHS, which occurs in the nondominant hand and is characterized mainly by intermanual conflict. Here, we report two cases of frontal-type alien hand syndrome with symptoms of reflexive grasping, impulsive groping, and apraxia (in case 1), and compulsive manipulation of tools (in case 2). Brain computed tomography revealed a left anterior cerebral artery (ACA) territory infarct and multiple small infarcts of both hemispheres in patient 1 and a left ACA infarct in patient 2. The involuntary movements were bothersome to these patients in their daily activities. Both patients attended conventional physical and occupational therapies, and patient 2 received additional biofeedback training. Follow-up studies showed the spontaneous grasping behavior was still present in patient 1 and AHS had subsided in patient 2. We also describe a potentially effective technique involving biofeedback for patients with alien hand syndrome.
异己手综合征（AHS）是指手部出现明显有目的的运动，且不受意志控制。AHS已被提出有两种亚型：额叶型AHS，表现为优势手出现抓握反射和对工具的强迫性操作；胼胝体型AHS，发生于非优势手，主要特征是双手冲突。在此，我们报告两例额叶型异己手综合征病例，一例（病例1）有反射性抓握、冲动性摸索和失用症症状，另一例（病例2）有对工具的强迫性操作症状。脑部计算机断层扫描显示，病例1左侧大脑前动脉（ACA）供血区梗死及双侧半球多发小梗死灶，病例2左侧ACA梗死。这些患者的非自主运动在日常活动中造成困扰。两名患者均接受了常规物理治疗和职业治疗，病例2还接受了额外的生物反馈训练。随访研究显示，病例1仍存在自发抓握行为，病例2的异己手综合征已消退。我们还描述了一种对异己手综合征患者可能有效的生物反馈技术。
