Doody R S, Jankovic J
Baylor College of Medicine, Department of Neurology, Houston, Texas 77030.
J Neurol Neurosurg Psychiatry. 1992 Sep;55(9):806-10. doi: 10.1136/jnnp.55.9.806.
Alien limb sign includes failure to recognise ownership of one's limb when visual cues are removed, a feeling that one body part is foreign, personification of the affected body part, and autonomous activity which is perceived as outside voluntary control. Although the hand is most frequently affected, any limb or combination of limbs may fulfil the alien limb criteria. Alien hand sign should be reserved for cases in which the hand feels foreign together with observable involuntary motor activity. To characterise this phenomenon, seven patients with alien hand sign and other motor or behavioural manifestations are described. Aetiologies included multiple infarcts and cortobasal ganglionic degeneration (CBD). In this study, all patients had apraxia in response to verbal commands and problems with bimanual coordination. Most displayed non-goal directed involuntary motor activities, and two had self destructive motor behaviours. Grasp reflex occurred with alien hand due to either aetiology. Cortical reflex myoclonus was frequently seen in CBD patients. The phenomenological spectrum is reviewed, a diagnostic protocol proposed, and possible anatomical bases of alien hand discussed.
异己肢体征包括在视觉线索被去除时无法识别自己肢体的所属感、感觉某个身体部位是陌生的、对受影响身体部位的人格化以及被视为超出自主控制的自主活动。尽管手最常受到影响，但任何肢体或肢体组合都可能符合异己肢体的标准。异己手征应仅用于手部感觉陌生且伴有可观察到的非自主运动活动的病例。为了描述这种现象，本文描述了7例患有异己手征及其他运动或行为表现的患者。病因包括多发性脑梗死和皮质基底节变性（CBD）。在本研究中，所有患者对言语指令均有失用症且存在双手协调问题。大多数患者表现出无目的的非自主运动活动，2例有自我毁灭的运动行为。由于任何一种病因，异己手都会出现抓握反射。皮质反射性肌阵挛在CBD患者中很常见。本文回顾了现象学范围，提出了诊断方案，并讨论了异己手可能的解剖学基础。
