WHAT IS ALIEN HAND SYNDROME?

When we see or hear of a condition, or symptom, more than once we begin to think there may be many more in the Parkinson’s world experiencing the same. They may not know what it is either, so we bring the information to you. Here at PRO, we have seen or heard of this symptom twice in the last couple of months.

We’ve taken excerpts from several online sources to provide this information to you... Healthline.com, NCBI PubMed.gov and About-Brains.com.

Alien Hand Syndrome (AHS) is a rare neurological condition that causes one hand to act on its own free will. Sometimes one leg is affected, though this isn’t as common.

With AHS, the hand isn’t under the control of the mind and moves as though it has its own mind. The affected hand feels foreign to its owner during these episodes and seems to move deliberately to carry out tasks that are unintentional.

While it can affect children, usually alien hand occurs in adults. It’s sometimes referred to as Dr. Strangelove syndrome, Strangelovian hand, or anarchic hand. You may remember watching Dr. Strangelove, the movie, some years back, finding Dr. Strangelove’s ordeal extremely funny, never suspecting that this remarkable affliction could exist in the real world.

It occurs in some cases after brain surgery, stroke, infection, tumor, aneurysm, migraine and specific neurodegenerative brain diseases such as Alzheimer’s disease and Creutzfeldt–Jakob disease (March 2017 Newsworthy Notes issue). Other areas of the brain that are associated with AHS are the frontal, occipital, and parietal lobes.

Alien Hand Syndrome is linked to brain surgeries that separate the two hemispheres of the brain. The corpus callosum divides the brain hemispheres and allows for communication between the two sides. Surgeries to treat epilepsy sometimes affect the brain in this way. Lesions may also be in the anterior cingulate cortex, posterior parietal cortex, and supplementary motor cortex areas of the brain.

Brain scans show that people with AHS have isolated activities in the primary motor cortex area. This is thought to be due to lesions or damage in the parietal lobe which integrates sensory information among various modalities, including spatial sense and navigation [proprioception], the main sensory receptive area for the sense of touch. This affects intentional planning systems and can cause spontaneous movements.

The most prominent symptom of Alien Hand Syndrome is the inability to control the hand as it acts independently. The affected hand may move involuntarily and perform goal-directed tasks and actions. The hand is said to move without cognitive control or awareness. It’s as though it’s being controlled by someone else or has a mind of its own.

The hand may touch your face, button a shirt, or pick up an object, sometimes repeatedly or compulsively. The alien hand may also levitate on its own. The hand may also engage in self-oppositional actions such as closing a drawer that the other hand just opened or unbuttoning a shirt that you just buttoned. The alien hand is uncooperative and may perform incorrect actions or fail to follow commands.

People with Alien Hand Syndrome may sense that the hand or limb is foreign or doesn’t belong to them. However, they don’t deny limb ownership, which can happen in other disorders. Diagnosing Alien Hand Syndrome is complicated because it’s a neurological disorder that lacks a psychiatric component. This makes it more difficult to diagnose because behavioral issues are more common than Alien Hand Syndrome. Symptoms can sometimes be attributed to a psychiatric disorder, which may be frustrating to the person affected.

The condition is treated or managed using muscle control therapies such as botulinum toxin (Botox) and neuromuscular blocking agents. Benzodiazepines have been successful in some cases, but behavioral techniques seem to be more beneficial.

Mirror box therapy, cognitive therapy techniques, and learning task behavioral therapies can help manage symptoms. Visuospatial coaching techniques may also help. Sometimes the individual will try to restrain their alien hand by holding it under or between their legs or sitting on it. Some people may find that it’s helpful to hold an object in the alien hand to prevent it from performing tasks.

It may help the individual with Alien Hand Syndrome or another person to give verbal commands to stop the actions. However, this method may not provide long-lasting results. A doctor may recommend physical and occupational therapies.

First recorded in 1909, Alien Hand Syndrome usually affects the left or nondominant hand.