scholarly journals Alien hand and complex regional pain syndromes during rehabilitation program

2021 ◽  
Author(s):  
Beata Tarnacka ◽  
Paweł Turczyn
Keyword(s):  
Corticobasal Degeneration ◽  
Pain Syndrome ◽  
Rehabilitation Program ◽  
Type I ◽  
Elbow Fracture ◽  
Left Hand ◽  
Alien Hand Syndrome ◽  
Regional Pain Syndromes ◽  
Complex Regional Pain Syndromes ◽  
Alien Hand

Introduction: Alien hand syndrome (AHS) belongs to the group of asymmetrical movement symptoms that are a characteristic picture of neurodegenerative diseases such as corticobasal degeneration syndrome (CBS). Changes in the musculoskeletal system such as dystonia, bradykinesia and myoclonus may also occur in the subacute stage of complex regional pain syndrome (CRPS) type I. Aim: To learn about difficulties related to diagnosis and rehabilitation of a patient with AHS and CRPS type I complicated by an upper limb fracture. Case study: A case of a patient admitted to the rehabilitation department with compulsive unilateral involuntary groping and grasping movements of the left hand for about half a year is presented. The woman has been suspected of CBS. A few months after the diagnosis, the patient was admitted to the rehabilitation ward, where she suffered an elbow fracture during exercise. Two months after fracture, type I CRPS was diagnosed. Results and discussion: AHS in CBS and CRPS type I may have a similar clinical picture, which makes differentiation difficult. It is very rare that both diseases coexist with each other. They can also lead to a number of unwanted symptoms such as limb fractures. Conclusions: CRPS may increase the symptoms of dystonia due to other causes. Patients with AHS and dystonia are more likely to break because of rapid movements alone or because of immobilization and osteoporotic changes. As a result, treatment and rehabilitation cannot be based on a questionable diagnosis of a neurological syndrome.

Sensory alien hand syndrome in corticobasal degeneration: A cerebral blood flow study

2010 ◽  
Vol 25 (9) ◽  
pp. 1288-1291 ◽  
Author(s):  
Julien Delrieu ◽  
Pierre Payoux ◽  
Olivier Toulza ◽  
Jean-Paul Esquerre ◽  
Bruno Vellas ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Corticobasal Degeneration ◽  
Alien Hand Syndrome ◽  
Alien Hand ◽  
Flow Study

scholarly journals Intermittent Alien Hand Syndrome and Callosal Apraxia in Multiple Sclerosis: Implications for Interhemispheric Communication

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
A. Lunardelli ◽  
A. Sartori ◽  
P. Mengotti ◽  
R. I. Rumiati ◽  
V. Pesavento
Keyword(s):  
Multiple Sclerosis ◽  
Corpus Callosum ◽  
Specific Pattern ◽  
Task Demands ◽  
Fine Motor ◽  
Interhemispheric Communication ◽  
Left Hand ◽  
Alien Hand Syndrome ◽  
Motor Activities ◽  
Alien Hand

We report a case of a 47-year-old woman with 35-year history of multiple sclerosis, who showed alien hand signs, a rare behavioural disorder that involves unilateral goal-directed movements that are contrary to the individual's intention. Alien hand syndrome has been described in multiple sclerosis (MS) only occasionally and is generally suggestive of callosal disconnection. The patient presented also with bilateral limb apraxia and left hand agraphia, raising the possibility of cortical dysfunction or disconnection, in addition to corpus callosum and white matter involvement. Her specific pattern of symptoms supports the role of the corpus callosum in interhemispheric communication for complex as well as fine motor activities and may indicate that it can serve as both an inhibitory and excitatory function depending on task demands.

scholarly journals Complex regional pain syndromes (CRPS) type 1 validating case histories

2003 ◽  
Vol 59 (1) ◽  
Author(s):  
P. Berger
Keyword(s):  
Electrical Stimulation ◽  
Pain Syndrome ◽  
Acute Stage ◽  
Motor Dysfunction ◽  
Case Histories ◽  
Pain Syndromes ◽  
Regional Pain Syndromes ◽  
Complex Regional Pain Syndromes ◽  
Careful Assessment

The treatment of patients with complex regional pain syndrome (CRPS) type 1 is challenging and unpredictable as the condition presents with vascular and neuropathic symptoms after nil or even minor injury to a peripheral nerve. The condition is one of a pain and motor dysfunction. The pathophysiology is not well understood and the relief of symptoms may change from being sympathetically mediated to sympathetically independent during  the course of the disease. At any stage physiotherapy has been advocated as the corner stone and most important aspect of treatment in the rehabilitation of these individuals but unfortunately it has been difficult to execute when pain is exacerbated due to allodynia (unbearable to touch or move) and hyperalgesia. Best results have been obtained if the patients are recognised and treated in the early or acute phase and it has been found that through careful assessment and analysis these patients can be recognised by previous events that have occurred in their initial case history. The treatment in the acute stage with physiotherapy modalities such as electrical stimulation and acupuncture will produce an early cessation of the symptoms and prevention of the disease developing into the fully blown CRPS type 1 with irreversible and possibly atrophic consequences. Case histories have been presented that illustrate these important aspects and demonstrate  the value of early and the appropriate physiotherapy that may be more successful than other pharmacological and physical interventions in this disease.

scholarly journals Potential Risk Factors for the Onset of Complex Regional Pain Syndrome Type 1: A Systematic Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-15 ◽  
Author(s):  
Tracey Pons ◽  
Edward A. Shipton ◽  
Jonathan Williman ◽  
Roger T. Mulder
Keyword(s):  
Risk Factors ◽  
Complex Regional Pain Syndrome ◽  
Potential Risk ◽  
Pain Syndrome ◽  
Syndrome Type ◽  
Regional Pain Syndromes ◽  
Wide Range ◽  
Complex Regional Pain Syndromes ◽  
Potential Risk Factors

Anaesthetists in the acute and chronic pain teams are often involved in treating Complex Regional Pain Syndromes. Current literature about the risk factors for the onset of Complex Regional Pain Syndrome Type 1 (CRPS 1) remains sparse. This syndrome has a low prevalence, a highly variable presentation, and no gold standard for diagnosis. In the research setting, the pathogenesis of the syndrome continues to be elusive. There is a growing body of literature that addresses efficacy of a wide range of interventions as well as the likely mechanisms that contribute to the onset of CRPS 1. The objective for this systematic search of the literature focuses on determining the potential risk factors for the onset of CRPS 1. Eligible articles were analysed, dated 1996 to April 2014, and potential risk factors for the onset of CRPS 1 were identified from 10 prospective and 6 retrospective studies. Potential risk factors for the onset of CRPS 1 were found to include being female, particularly postmenopausal female, ankle dislocation or intra-articular fracture, immobilisation, and a report of higher than usual levels of pain in the early phases of trauma. It is not possible to draw definite conclusions as this evidence is heterogeneous and of mixed quality, relevance, and weighting strength against bias and has not been confirmed across multiple trials or in homogenous studies.

scholarly journals Alien hand syndrome in AIDS: Neuropsychological features and physiopathological considerations based on a case report

2007 ◽  
Vol 1 (4) ◽  
pp. 418-421 ◽  
Author(s):  
Leonardo Caixeta ◽  
Patrícia Maciel ◽  
Juliana Nunes ◽  
Larissa Nazareno ◽  
Letícia Araújo ◽  
...  
Keyword(s):  
Visual Cues ◽  
Memory Loss ◽  
Epidemiological Data ◽  
Left Hand ◽  
Left Handed ◽  
Clinical Presentations ◽  
Alien Hand Syndrome ◽  
Old Left ◽  
Alien Hand ◽  
The Right

Abstract Alien hand syndrome consists of an autonomous motor activity perceived as an involuntary yet purposeful movement, with a feeling of foreignness of the involved limb, commonly associated with a failure to recognize ownership of the limb in the absence of visual cues. A 41 year old left-handed woman, HIV positive, evolved with loss of control in the left hand. Her left hand presented extravolitional movements, as if having a will of its own, not responding to commands such as opening a door or holding an umbrella, but instead groping unneeded objects. She had talked to her hand and even fought it. In addition, other clinical presentations including recent memory loss, hemineglect and dysphoria were observed. Computed tomography revealed a hypodensity area in the right frontal-parietal region, with midline deviation. Considering clinical and epidemiological data, the diagnosis of Central Nervous System (CNS) toxoplasmosis was reached. No previous reports showing association among AIDS, toxoplasmosis and alien hand syndrome were found.

scholarly journals Case Report: Good Prognosis of Mixed Alien Hand Syndrome by Verbal-Cue Rehabilitation Exercise

2021 ◽  
Vol 12 ◽  
Author(s):  
Kang Qu ◽  
Lin Gan ◽  
Wei Jiang ◽  
Peng Yu ◽  
Ming Dong
Keyword(s):  
Corpus Callosum ◽  
Single Case ◽  
Good Prognosis ◽  
Hand Movements ◽  
Left Hand ◽  
Left Handed ◽  
Alien Hand Syndrome ◽  
Before And After ◽  
Alien Hand ◽  
The Right

Mixed alien hand syndrome is a rare disease reported in the literature. The mixed callosal–frontal variant of alien hand syndrome is associated with uncoordinated hand movements, and patients may present with an involuntary grasp reflex and intermanual conflict. There are few videos in the existing literature on the comparison of patients' condition before and after recovery of the symptoms of mixed alien hand syndrome. We presented the prognosis of mixed alien hand syndrome in the form of a video. In addition, we have included some videos on the comparison of the condition of patients before and after recovery of the symptoms of mixed alien hand syndrome. A 57-year-old woman presented with left-handed intermanual conflict and right-handed involuntary grasp reflex due to infarction of the frontal lobe and corpus callosum. She was diagnosed with a mixed callosal–frontal variant of alien hand syndrome. Her left hand counteracted the purposeful movements of the right hand. However, the intermanual conflict disappeared after 3 months of therapy, including drug treatment and verbal-cue rehabilitation, and she regained normal coordination of her hand movements. Her prognosis was good despite the large corpus callosum lesions. The uncoordinated hand movements of the patient affected her daily life and caused psychological problems. Initiating rehabilitation early was important and necessary for her to regain coordination. It is possible that the verbal-cue training method played an important role in the recovery of the patient. Therefore, this method of rehabilitation deserves consideration and can be adopted in larger cohort studies as we presented only a single case. The possible mechanisms behind the verbal-cue exercise require further studies, and this patient had a good prognosis despite severe corpus callosum injury, which may merit further investigation.

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