Bru Inge, Verhamme Lisa, de Neve Pascal, Maebe Hanne
Department of Physical and Rehabilitation Medicine, BZIO, Bundeling Zorg Initiatieven Oostende (translation: Bundling of Care Initiatives Ostend), Ostend, Belgium.
J Rehabil Med Clin Commun. 2021 Feb 24;4:1000050. doi: 10.2340/20030711-1000050. eCollection 2021.
Alien hand syndrome is a rare neurological disorder in which the patient makes seemingly purposeful movements of one hand, which are dissociated from any conscious intent. These abnormal movements are very annoying, and can be disabling, for the patient. There is no established effective treatment for alien hand syndrome.
Report of a case of a 61-year old man with frontal variant of alien hand syndrome following ischaemic stroke.
During therapy, the patient unwittingly grabbed objects with his right hand and could not voluntarily release his grip. Multidisciplinary rehabilitation was started, with learning of compensation strategies and a focus on bimanual tasks. Follow-up after 5 months showed a major improvement in the Functional Index Measure (FIM) score, an improvement from 36 to 79 on 126 scored items.
It is important to recognize this rare syndrome because of its disabling character. Evidence about the best treatment for alien hand syndrome is scarce. There is an important role for specific exercises and patient education. During rehabilitation of the patient, most improvement occurred with bimanual tasks and different colours (black, white and other bright colours) to navigate the subject's attention more to one side. Another exercise strategy was letting the alien hand catch a cube, after which the patient was able to perform more exercises with the other hand during one - handed training. In the current case, the alien hand syndrome resolved following specific and multidisciplinary rehabilitation.
异己手综合征是一种罕见的神经系统疾病，患者的一只手会做出看似有目的的动作，而这些动作与任何有意识的意图无关。这些异常动作对患者来说非常恼人，甚至可能导致残疾。目前尚无针对异己手综合征的确立有效的治疗方法。
报告一例61岁男性在缺血性中风后出现额叶型异己手综合征的病例。
在治疗过程中，患者右手会不自觉地抓取物体，且无法自主松开。于是开始了多学科康复治疗，包括学习补偿策略并专注于双手任务。5个月后的随访显示，功能指数测量（FIM）评分有了显著改善，在126个计分项目上从36分提高到了79分。
鉴于其致残性，认识这种罕见综合征很重要。关于异己手综合征最佳治疗方法的证据很少。特定的锻炼和患者教育起着重要作用。在患者康复过程中，双手任务以及使用不同颜色（黑色、白色和其他亮色）将患者的注意力更多地引向一侧时，改善最为明显。另一种锻炼策略是让异己手接住一个立方体，之后患者在单手训练时能用另一只手进行更多锻炼。在当前病例中，经过特定的多学科康复治疗后，异己手综合征得到了缓解。
