Hidalgo-Borrajo R, Belaunzaran-Mendizábal J, Hernáez-Goñi P, Tirapu-Ustárroz J, Luna-Lario P
Clínica Ubarmin, Elcano, Navarra, España.
Rev Neurol. 2009;48(10):534-9.
Alien hand syndrome (AHS) is a rare neurological disorder, but is an important condition because of its disabling impact on the daily life. The common feature of AHS is the involuntary, autonomous motor activity of the affected limb and the denial of limb ownership, characterized by involuntary, uncontrollable, and purposeless movements.
AHS as a nosologic entity has been modified during the last decades, being able to be a result of several diseases involving corpus callosum or medial frontal cortex, although some authors reported cases of AHS in patients due to posterior cerebral lesions. Frontal AHS occurs in the dominant hand, is associated with grasping, groping and compulsive manipulation of tools. Callosal subtype is characterized by inter-manual conflict and was the first to been described en the context of callosal disconnection.
Alien hand behaviours are increased in conditions of fatigue or anxiety and are usually elicited by nearby objects. The rehabilitative treatment, targeted toward the specific needs of each patient, could allow the improvement of the activities of daily life.
异己手综合征(AHS)是一种罕见的神经系统疾病,但因其对日常生活的致残影响而成为一种重要病症。AHS的共同特征是患肢出现不自主、自主的运动行为以及对肢体所有权的否认,其表现为不自主、无法控制且无目的的动作。
作为一种疾病实体,AHS在过去几十年中已有变化,它可能是涉及胼胝体或额叶内侧皮质的多种疾病的结果,尽管一些作者报告了因大脑后病变导致患者出现AHS的病例。额叶型AHS发生在优势手,与抓握、摸索和对工具的强迫性操作有关。胼胝体型的特征是双手冲突,并且是在胼胝体分离的背景下首次被描述。
在疲劳或焦虑状态下,异己手行为会增加,并且通常由附近的物体引发。针对每个患者的特定需求进行康复治疗,可能会改善日常生活活动能力。