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Related Experiment Videos

Sleep disorder in alien hand syndrome.

J J Ortega-Albás1, M de Entrambasaguas, F J Montoya

  • 1Sleep Unit, Department of Clinical Neurophysiology, Hospital General de Castellón, Avenida de Benicàssim s/n, E-12004 Castellón, Spain. ortega_jua@gva.es

Sleep Medicine
|November 1, 2003
PubMed
Summary

Alien Hand Syndrome (AHS) involves involuntary movements of a hand, often occurring during wakefulness after a stroke. This case highlights AHS movements emerging from specific sleep stages, suggesting novel neurological control mechanisms.

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Area of Science:

  • Neuroscience
  • Neurology
  • Sleep Medicine

Background:

  • Alien Hand Syndrome (AHS) is a rare neurological disorder characterized by a perceived lack of control over a limb.
  • Stroke, particularly involving the anterior cerebral artery, can precipitate AHS, leading to significant patient distress and functional impairment.

Observation:

  • A 63-year-old woman with a left anterior cerebral artery infarction developed AHS with prominent daytime motor activity.
  • Polysomnography revealed that these involuntary movements occurred exclusively during wakefulness, often emerging from NREM sleep stage 2.
  • No epileptiform activity, dyssomnia, or parasomnia were identified, differentiating AHS from other sleep-related movement disorders.

Findings:

  • The alien hand movements in this patient were strictly associated with the awake state, despite initial concerns about sleep disturbance.

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  • The temporal pattern of motor activity suggested a link to the natural hyperpolarization of anterior horn neurons during sleep progression.
  • The grasp reflex accommodation appeared to play a role in managing the unwanted motor activity.

    • Implications:

    • This case expands the understanding of AHS pathophysiology, suggesting a complex interplay between cortical and subcortical structures.
    • The findings underscore the importance of detailed polysomnographic evaluation to differentiate AHS from other movement disorders, especially those affecting sleep.
    • Further research into the neural mechanisms underlying AHS could lead to targeted therapeutic strategies for motor control disorders.