Overview
Alien hand syndrome (AHS) is a rare neurological disorder where a limb acts independently, performing complex, purposeful movements without conscious control. Though rare, it can sometimes also affect your legs. The condition results from damage to specific part of the brain that control movement,
This phenomenon can be a terrifying experience. You might feel like you’ve entered a horror movie and someone or something else is controlling this part of your body. Alien hand syndrome can happen with several underlying conditions or trauma, as well as after some types of brain surgery. There is no known cure available for alien hand syndrome. A Healthcare provider may recommend physical therapy, occupational therapy or cognitive behavioral therapy to manage and improve your physical and mental health.
Symptoms
- Involuntary Grasping and Groping: The hand compulsively grabs nearby objects or gropes parts of the body.
- Inability to Release Objects: Once the alien hand clutches an object, the patient often cannot consciously force it to let go, sometimes requiring the functional hand to pry the fingers open.
- Intermanual Conflict: The affected hand actively opposes the actions of the healthy hand. For example, if the functional hand buttons a shirt or opens a drawer, the alien hand may immediately unbutton the shirt or close the drawer.
- Compulsive Task Execution: The hand may independently perform complex, habitual tasks like picking up a tool, manipulating eating utensils, or tearing the clothes the patient is wearing
- Self-Harm Behaviors (Rare): In extreme cases the hand may slap, scratch, or even attempt to choke the patient.
Causes
The symptoms of alien hand syndrome vary but could include the following
- Corpus callosum: The middle of your brain between the right and left hemispheres.
- Parietal region: The top, back part of your brain, under the crown of your skull.
- Frontal region: The part of your brain behind your forehead.
Risk Factors
- Corticobasal Syndrome (CBS): This atypical Parkinsonian variant carries the highest risk
- Ischemic or Hemorrhagic Stroke: Stroke is the most common cause of sudden-onset AHS. Infarctions specifically involving the anterior cerebral artery or the corpus callosum carry the highest probability.
- Creutzfeldt-Jakob Disease (CJD): Roughly 4% of individuals with this rapid neurodegenerative disease experience AHS.
- Refractory Epilepsy Surgery: Patients who undergo a corpus callosotomy—a surgical procedure that splits the brain hemispheres to control severe seizures—are at significant risk due to the disruption of interhemispheric communication.
Diagnosis
- Magnetic Resonance Imaging (MRI): The primary tool used to detect structural injuries, such as recent strokes, tumors, or localized tissue shrinkage.
- Psychiatric Disorders: Conditions like schizophrenia or dissociative disorders where patients report a loss of agency over their body, though AHS has entirely structural—not psychiatric—roots.
- Hemispatial Neglect: A stroke complication where a patient entirely ignores one side of their environment or body, distinct from the active, autonomous movements of AHS
Tests
There isn’t a specific test to diagnose alien hand syndrome. A healthcare provider will review your symptoms and observe your movements during a physical exam. Let them know if you had brain surgery or a head injury.
Several medical conditions can cause involuntary movements. Tests can rule out conditions with similar symptoms. Your provider may order an imaging test like an MRI (magnetic resonance imaging) to look for lesions in your brain.
Management and Treatment
A healthcare provider may offer treatment options to manage any underlying conditions or reduce symptoms of alien hand syndrome, like:
- Medications. A provider may treat involuntary movements with antiseizure medications or neuromuscular blocking agents. Other medications may be an option depending on what symptoms you experience.
- Botulinum toxin injections. Botulinum toxin can temporarily prevent muscle movement in an area of your body. This can help with involuntary movements, but repeat treatment is necessary after several months.
- Mirror box therapy. A mirror can create an illusion to convince your brain to believe that one of your limbs moved voluntarily and is within your control.
- Distractions. If your affected hand grasps objects often, you can place a ball or soft object within reach to distract it. You can also place this hand in a pocket to prevent any unanticipated actions.
- Therapies. A provider may recommend physical therapy, occupational therapy or cognitive behavioral therapy to improve your physical and mental health.
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