Intermittent alien hand syndrome and callosal apraxia in multiple sclerosis: implications for interhemispheric...

Area of Science:

• Neuroscience
• Neurology
• Clinical Case Study

Background:

• Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system.
• Alien hand syndrome (AHS) is a rare neurological disorder characterized by purposeful yet uncontrollable movements of a limb.
• AHS in MS is infrequently reported and often associated with callosal disconnection.

Observation:

• A 47-year-old woman with a 35-year history of MS presented with alien hand syndrome.
• The patient also exhibited bilateral limb apraxia and left-hand agraphia.
• Neuroimaging suggested involvement of the corpus callosum and white matter.

Findings:

• The patient's complex neurological presentation suggested both cortical and callosal dysfunction.
• The specific symptom constellation supports the corpus callosum's critical role in interhemispheric motor control.
• Findings indicate the corpus callosum may mediate both inhibitory and excitatory functions in motor activity.

Implications:

• This case underscores the diverse and complex neurological manifestations of multiple sclerosis.
• It emphasizes the corpus callosum's significance in coordinating complex and fine motor skills.
• Understanding callosal function in MS may inform future therapeutic strategies for motor control deficits.