Feinberg T E, Schindler R J, Flanagan N G, Haber L D
Neurobehavior Center, Beth Israel Medical Center, New York, NY 10003.
Neurology. 1992 Jan;42(1):19-24. doi: 10.1212/wnl.42.1.19.
Review of the clinical characteristics and neuroanatomy of 20 reported cases of alien hand syndrome (AHS) and a patient of our own confirm that AHS is actually two distinct syndromes. Frontal AHS occurs in the dominant hand; is associated with reflexive grasping, groping, and compulsive manipulation of tools; and results from damage to the supplementary motor area, anterior cingulate gyrus, and medial prefrontal cortex of the dominant hemisphere and anterior corpus callosum. Callosal AHS is characterized primarily by intermanual conflict and requires only an anterior callosal lesion. the occurrence of frontal AHS in the dominant limb can be explained by an increased tendency for dominant limb exploratory reflexes coupled with release from an asymmetrically distributed, predominant nondominant-hemisphere inhibition. Callosal AHS is best explained by hemispheric disconnection manifested during behaviors requiring dominant-hemisphere control.
对20例已报道的异己手综合征（AHS）病例及1例我院患者的临床特征和神经解剖学回顾证实，AHS实际上是两种不同的综合征。额叶型AHS发生于优势手；与反射性抓握、摸索和对工具的强迫性操作有关；由优势半球的辅助运动区、前扣带回和内侧前额叶皮质以及胼胝体前部受损所致。胼胝体型AHS主要表现为双手冲突，仅需胼胝体前部病变。优势肢体出现额叶型AHS可解释为优势肢体探索反射倾向增加，同时解除了非优势半球不对称分布的优势抑制。胼胝体型AHS最好解释为在需要优势半球控制的行为中表现出的半球分离。
