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Kessler Institute
for Rehabilitation, 300 Market Street, Saddle Brook, NJ 07663, USA
Correspondence to: Dr T Bundick Jr, Staten Island University Hospital, Rehabilitation Medicine, 242 Mason Avenue, Staten Island, MY 10305, USA.
Received 16 November
1998 and in revised form 23 March 1999;
Accepted 6 May
1999
The alien hand syndrome, as originally defined, was used
to describe cases involving anterior corpus callosal lesions producing involuntary movement and a concomitant inability to distinguish the
affected hand from an examiner's hand when these were placed in the
patient's unaffected hand. In recent years, acceptable usage of the
term has broadened considerably, and has been defined as involuntary
movement occurring in the context of feelings of estrangement from or
personification of the affected limb or its movements. Three varieties
of alien hand syndrome have been reported, involving lesions of the
corpus callosum alone, the corpus callosum plus dominant medial frontal
cortex, and posterior cortical/subcortical areas. A patient with
posterior alien hand syndrome of vascular aetiology is reported and the
findings are discussed in the light of a conceptualisation of posterior
alien hand syndrome as a disorder which may be less associated with
specific focal neuropathology than are its callosal and
callosal-frontal counterparts.
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