Alien hand syndrome makes the person with it feel like their hand doesn’t belong to them and they’re living their own life. Although perceived as attached to the body, the hand seems to act autonomously.
Definition: What is Alien Hand Syndrome?
Alien hand syndrome is a rare neurological disorder in which a person loses conscious control of one of their hands, who seems to be acting independently of his will. The affected hand may perform actions that are in opposition to the actions of the person or the other hand, which can be very disturbing for the affected person. “This syndrome is usually associated with brain damage, such as a tumor or strokebut can also be caused by neurodegenerative disease such as corticobasal degeneration or Lewy body disease, details Professor Frédéric Assal, neurologist. There is currently no treatment for this rare syndrome when it persists.”
Who discovered alien hand syndrome?
“We owe the term “foreign hand” to two French neurologists, Doctors Bryon and Jedynak who have described the syndrome in cases of lesions of the corpus callosum, the structure that unites the 2 cerebral hemispherescontinues Professor Assal. Subsequently, the syndrome was enriched with several sub-variants which correspond to the clinical descriptions of isolated cases dating from the end of the 19th and the beginning of the 20th century“Over the past few decades, many physicians and researchers have continued to study the syndrome and describe its features, which has contributed to a better understanding of the condition and the development of potentially effective treatment approaches.”The alien hand syndrome described in the 1970s was popularized by the film “Doctor Strangelove” by Stanley Kubrick. In the film, the main character is forced to play a game of poker with a hand that seems to have a life of its own and acts without his control. Although alien hand syndrome is an actual term used around the world medical to describe a movement disorder, it has no direct connection with the manipulation of time or space“. It is important not to confuse the fiction of the film with the medical reality.
What causes alien hand syndrome?
The exact cause of alien hand syndrome is not known for sure. “But it is usually associated with brain damage that affects the sensory-motor regions of the brainresponsible for the coordination and planning of movements“, specifies the neurologist. Among the most frequent causes, one can quote:
► Cerebrovascular accident (CVA): a CVA can damage areas of the brain that control voluntary movement, which can lead to problems with coordination and hand control.
► brain tumors : “Brain tumors can squeeze or damage regions of the brain responsible for coordinating and planning movement, which can lead to symptoms similar to alien hand syndrome.”.
► Neurodegenerative diseases : “certain neurodegenerative diseases such as corticobasal degeneration or Lewy body disease can also lead to symptoms similar to foreign hand syndrome by affecting the regions of the brain responsible for the coordination and planning of movements.
► brain surgery : Brain surgery to treat conditions like epilepsy can also lead to brain damage that can cause symptoms similar to alien hand syndrome.
It is important to note that alien hand syndrome is very rare and that most people with a brain injury or neurodegenerative disease do not develop this syndrome.
What are the symptoms of alien hand syndrome?
“Symptoms of alien hand syndrome may vary depending on the severity of the brain injury or underlying disease“, recognizes the Professor. The most common symptoms are:
► Loss of control over the hand : “The person may feel that their hand is acting outside of their control and may perform actions that are in opposition to the actions of the person or the other hand“.
► Involuntary actions : The affected hand may perform involuntary actions such as twisting, flapping or pinching movements, which may be painful for the person.
► Resistance to efforts to control the hand : The person may find it difficult to control the affected hand, even when actively trying to do so, which can cause frustration and anxiety.
► Pain or discomfort : “The person may experience pain or discomfort in the affected hand, which may be exacerbated by involuntary actions of the hand“.
► Impaired ability to perform simple tasks : Loss of control over the hand can make it difficult to perform simple tasks such as dressing, brushing teeth, or holding objects.
“Symptoms may change over time, sometimes regress in the case of tumor surgery or persist because there is no treatment“.
“There is no effective treatment except in case of associated pain”
How to diagnose alien hand syndrome?
The diagnosis of alien hand syndrome is based on a detailed medical examination, which may include the following:
► Medical history : The doctor may ask questions about the patient’s general health, medical history, and history of injuries or illnesses.
► Neurological examination : “The doctor may perform an examination of your hands and arms to assess your ability to control your movements and your ability to feel sensations such as pain or touch, assess strength, coordination and the ability to control movement of your hands and arms“, adds our interlocutor.
► Assessing the ability to perform simple tasks : The doctor may assess your ability to perform simple tasks such as dressing, brushing your teeth or holding objects to assess the impact of your symptoms on your daily life.
► brain imaging : “The doctor may recommend brain imaging tests such as brain MRI or PET-FDG brain metabolism exam to assess the condition of your brain and look for abnormalities that could explain your symptoms“. “The diagnosis of alien hand syndrome is very complex and requires the opinion of a neurologist”.
What is the treatment for alien hand syndrome?
“The treatment for foreign hand syndrome depends on the underlying cause knowing that when the syndrome is persistent, there is no treatment. It rests on a multidisciplinary medical approach and other care partners (physiotherapists, occupational therapists, psychologists)“, recalls the specialist. Physiotherapy and occupational therapy: “of the strengthening exercises, stretching and daily chores activities can improve the ability to control movements and above all limit the symptoms often associated with stiffness“. Cognitive-behavioral therapy : “it can help manage the anxieties and worries associated with alien hand syndrome“. Medications : “there is no effective treatment except in case of associated pain or sometimes the painkillers can be a relief“. Surgical interventions : “In some cases, surgery may be necessary to treat, for example, brain tumors“.”Of the deep electrical stimulation treatments of the brain are being studied but not yet used on a large scale clinically“.
Thanks to Professor Frédéric Assal, Head of the Neuropsychology and Behavioral Neurology Unit of the University Hospitals of Geneva (HUG) and lecturer at the Faculty of Medicine of Geneva.