Chan J L, Chen R S, Ng K K
Department of Neurology, Chang Gung Memorial Hospital and College of Medicine and Technology, Taipei, Taiwan, ROC.
J Formos Med Assoc. 1996 Apr;95(4):342-6.
A patient with left alien hand syndrome (AHS) accompanied by leg symptoms due to right anterior cerebral artery territory infarction is reported. Magnetic resonance imaging demonstrated that the responsible lesion involved the right anterior cingulate gyrus, supplementary motor area, medical prefrontal cortex and corpus callosum extending from the genu to the isthmus. The leg symptoms included: 1) motor perseveration manifesting as compulsive straight walking with difficulty stopping on command; 2) dissociation between mind and action resulting in going to unintended places with subsequent complaints of poor memory not due to spatial disorientation; 3) discrepancy between verbal and actual leg motor responses to auditory verbal suggestions; and 4) movement dissociation between the legs resulting in transient standing still or brief sticking to the ground, a situation simulating akinesia. As the legs usually perform together to coordinate movements of standing and walking, unlike the hands performing well-learned, skilled unimanual or bimanual coordinating movements, the counterpart in the leg of the alien hand sign in AHS was not manifested. Nevertheless, in the presence of AHS, the associated leg symptoms bear similar neurobehavioral features and should be dealt with on equal terms.
报告了一名因右侧大脑前动脉供血区梗死而患有左侧异手综合征（AHS）并伴有腿部症状的患者。磁共振成像显示，责任病灶累及右侧扣带回、辅助运动区、内侧前额叶皮质以及从胼胝体膝部延伸至峡部的胼胝体。腿部症状包括：1）运动持续，表现为强迫性直行，难以按指令停止；2）思维与行动分离，导致前往非预期地点，随后抱怨记忆力差，但并非由于空间定向障碍；3）对听觉言语提示的腿部言语和实际运动反应之间存在差异；4）双腿运动分离，导致短暂站立不动或短暂粘在地面上，类似于运动不能的情况。由于双腿通常协同执行站立和行走的协调运动，与双手执行熟练掌握的单手动或双手协调运动不同，AHS中异手征在腿部的对应表现未显现。然而，在存在AHS的情况下，相关的腿部症状具有相似的神经行为特征，应同等对待。
