目的 总结异己手综合征(AHS)的临床特征,探讨其发病机制及诊疗要点。方法 回顾性分析2015年7月至2017年7月8例AHS住院患者的原发病、临床表现、影像学特点及预后。结果 8例AHS患者全部为脑血管病;临床表现多样,包括异己手8例、运动障碍8例、认知障碍5例、言语障碍4例、情感障碍3例;影像学提示病灶累及胼胝体8例、额叶8例、顶叶3例、颞叶2例、基底节区1例;经药物及康复治疗,4例治愈,2例好转,2例改善。结论 AHS的病因以脑血管病多见,多累及胼胝体及额叶,临床表现多样,预后良好。
Objective To report the clinical characteristics of alien hand syndrome (AHS). Methods Eight AHS inpatients from July, 2015 to July, 2017 were reviewed from the etiology, clinical manifestations, imaging characteristics and outcome. Results The etiology of the patients was cerebrovascular disease. The clinical features included alien hand (8 cases), movement disorder (8 cases), cognitive disorder (5 cases), speech disorder (4 cases) and affective disorder (3 cases). Imaging indicated the lesions involved callosum (8 cases), frontal lobe (2 cases), parietal lobe (3 cases), temporal lobe (2 cases) and basal ganglial region (1 case). There were four cases healing, two improving, two of remission after medicine and rehabilitation.Conclusion ASH is mainly resulted from cerebrovascular disease, in which callosum and frontal lobe are mostly involved, features in different forms, and prognoses well.
[1] Olgiati E, Maravita A, Spandri V, et al.Body schema and corporeal self-recognition in the alien hand syndrome[J]. Neuropsychology, 2017, 31(5): 575-584.
[2] Olszewska DA, McCarthy A, Murray B, et al. A wolf in sheep's clothing: An "Alien Leg" in corticobasal syndrome[J]. Tremor Other Hyperkinet Mov (N Y), 2017, 7: 455.
[3] Graff-Radford J, Rubin MN, Jones DT, et al.The alien limb phenomenon[J]. J Neurol, 2013, 260(7): 1880-1888.
[4] Demiryürek BE, Gündogdu AA, Acar BA, et al.Paroxysmal posterior variant alien hand syndrome associated with parietal lobe infarction: case presentation[J]. Cogn Neurodyn, 2016, 10(5): 453-455.
[5] Yulug B, Hanoglu L, Cakir T, et al.Pure posterior alien hand syndrome following a cerebrovascular lesion: clinicoradiological correlates[J]. J Clin Neurol, 2016, 12(2): 243-244.
[6] Biran I, Giovannetti T, Buxbaum L, et al.The alien hand syndrome: What makes the alien hand alien?[J]. Cogn Neuropsychol, 2006, 23(4): 563-582.
[7] 王笑丰,邹飒枫. 异己手综合征患者的康复1例报告[J]. 中国康复医学杂志, 2016, 31(1): 93-95.
[8] Lunardelli A, Sartori A, Mengotti P, et al.Intermittent alien hand syndrome and callosal apraxia in multiple sclerosis: implications for interhemispheric communication[J]. Behav Neurol, 2014, 2014: 873541.
[9] Rubin M, Graff-Radford J, Boeve B, et al.The alien limb phenomenon and Creutzfeldt-Jakob disease[J]. Parkinsonism Relat Disord, 2012, 18(7): 842-846.
[10] 董琦,王利平,高宇,等. 异己手综合征1例报告及文献复习[J]. 中风与神经疾病杂志, 2015, 32(8): 753-754.
[11] Aboitiz F, Carrasco X, Schröter C, et al.The alien hand syndrome: classification of forms reported and discussion of a new condition[J]. Neurol Sci, 2003, 24(4): 252-257.
[12] Hassan A, Josephs KA.Alien hand syndrome[J]. Curr Neurol Neurosci Rep, 2016, 16(8): 73.
[13] Brugger F, Galovic M, Weder BJ, et al.Supplementary motor complex and disturbed motor control–a retrospective clinical and lesion analysis of patients after anterior cerebral artery stroke[J]. Front Neurol, 2015, 6: 209.
[14] Jang SH, Kwon HG.Development of alien hand syndrome with degeneration of transcallosal fibers to the supplementary motor area: a case report[J]. Int J Stroke, 2015, 10(4): E40-E41.
[15] Ridley B, Beltramone M, Wirsich J, et al.Alien hand, restless brain: salience network and interhemispheric connectivity disruption parallel emergence and extinction of diagonistic dyspraxia[J]. Front Hum Neurosci, 2016, 10: 307.
[16] Mahawish K.Corpus callosum infarction presenting with anarchic hand syndrome[J]. Bmj Case Reports, 2016, 2016: bcr2016216071.
[17] Kim HY, Kim JY, Kim GU, et al.Alien hand syndrome after epilepsia partialis continua: FDG PET and MRI studies[J]. Epilepsy Behav, 2012, 23(1): 71-73.
[18] Gao X, Li B, Chu W, et al.Alien hand syndrome following corpus callosum infarction: A case report and review of the literature[J]. Exp Ther Med, 2016, 12(4): 2129-2135.
[19] de Assis Aquino Gondim F. Sensory alien limb syndrome in stroke and corticobasal syndrome[J]. Mov Disord, 2011, 26(7): 1365-1366.
[20] Rafiei N, Chang GY.Right sensory alien hand phenomenon from a left pontine hemorrhage[J]. J Clin Neurol, 2009, 5(1): 46-48.
[21] Gondim Fde A, Tavares Júnior JW, Morais AA, et al.Alien limb syndrome responsive to amantadine in a patient with corticobasal syndrome[J]. Tremor Other Hyperkinet Mov (N Y), 2015, 5: 309.
[22] Sarva H, Deik A, Severt WL.Pathophysiology and treatment of alien hand syndrome[J]. Tremor Other Hyperkinet Mov (N Y), 2014, 4: 241.
[23] Schaefer M, Heinze HJ, Galazky I.Waking up the alien hand: rubber hand illusion interacts with alien hand syndrome[J]. Neurocase, 2013, 19(4): 371-376.
[24] Haq IU, Malaty IA, Okun MS, et al.Clonazepam and botulinum toxin for the treatment of alien limb phenomenon[J]. Neurologist, 2010, 16(2): 106-108.
