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脑胼胝体和扣带回梗死所致的罕见性“幻手综合征”

Alien hand syndrome, a rare presentation of corpus callosum and cingulate infarction.

机构信息

Department of Neurology, The First Hospital of China Medical University, Shenyang City, Liaoning Province, China.

Department of Neurology, The First Hospital of China Medical University, Shenyang City, Liaoning Province, China.

出版信息

J Neurol Sci. 2023 Sep 15;452:120739. doi: 10.1016/j.jns.2023.120739. Epub 2023 Jul 24.

Abstract

Alien hand syndrome (AHS) is a rare apraxia syndrome, characterized by involuntary and uncontrollable movements of one upper limb, often accompanied by intermanual conflict. Damage to the corpus callosum, acute infarction and neurodegenerative disease may result in AHS. Based on the presentation and impairment region, AHS has three variants: frontal, callosal and posterior. Each type may have a different clinical presentation. A total of 157 patients admitted to hospital with corpus callosum infarction between 2012 and 2022 were included for this study, of whom a number of 5 presented with AHS. 4 of them had significant symptoms of intermanual conflict and 1 had strong grip symptoms in the affected upper limb. Moreover, new infarcts involving the corpus callosum and cingulate gyrus were found on MRI in all five patients. We simultaneously performed a retrospective study on all reported AHS cases caused by infarction of the corpus callosum. Case reports and literature reviews were conducted in order to provide clinicians with a better understanding of AHS, its etiology, clinical presentation, diagnosis, and treatment.

摘要

异手综合征(AHS)是一种罕见的运动失调综合征,其特征为单侧上肢出现不自主和无法控制的运动,常伴有双手冲突。胼胝体损伤、急性梗死和神经退行性疾病均可导致 AHS。根据表现和损伤部位,AHS 有三种变异型:额状型、胼胝体型和后型。每种类型可能有不同的临床表现。本研究共纳入了 2012 年至 2022 年间因胼胝体梗死住院的 157 名患者,其中 5 名患者出现 AHS。其中 4 名患者有明显的双手冲突症状,1 名患者患侧上肢有强烈的握持症状。此外,5 名患者的 MRI 均显示新的胼胝体和扣带回梗死。我们同时对所有报告的由胼胝体梗死引起的 AHS 病例进行了回顾性研究。通过病例报告和文献复习,旨在为临床医生提供更好地了解 AHS 的病因、临床表现、诊断和治疗方法。

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