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Related Experiment Video

Updated: Jan 28, 2026

Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
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Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis

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[Unique Hand Muscle Atrophy: The Split Hand Symptom].

Kazumoto Shibuya1

  • 1Chiba University, Graduate School of Medicine, Department of Neurology.

Brain and Nerve = Shinkei Kenkyu No Shinpo
|March 5, 2019
PubMed
Summary

Amyotrophic lateral sclerosis (ALS) diagnosis is aided by the split hand symptom, where specific hand muscles atrophy differently. This distinct pattern helps differentiate ALS from other conditions causing upper limb atrophy.

Area of Science:

  • Neurology
  • Neuroscience
  • Clinical Medicine

Background:

  • Upper limb atrophy can stem from various neurological conditions, including ALS and cervical spondylotic amyotrophy.
  • Accurate diagnosis is crucial due to the differing prognoses and management strategies for these conditions.
  • The split hand symptom is a key clinical sign that warrants further investigation.

Purpose of the Study:

  • To highlight the diagnostic significance of the split hand symptom in amyotrophic lateral sclerosis (ALS).
  • To present a case study of an ALS patient exhibiting the split hand symptom.
  • To review current research on ALS, the utility of the split hand symptom, and its underlying pathological mechanisms.

Main Methods:

  • Clinical case presentation of an amyotrophic lateral sclerosis patient.

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  • Review of recent advances in amyotrophic lateral sclerosis research.
  • Analysis of the diagnostic utility and pathological basis of the split hand symptom.

    • Main Results:

    • The split hand symptom, characterized by preferential atrophy of thenar and first dorsal interosseous (FDI) muscles with relative preservation of the abductor digiti minimi (ADM) muscle, was observed.
    • This differential muscle involvement, despite shared innervation, suggests a specific pathological mechanism in ALS.
    • The presented case exemplifies the clinical presentation and diagnostic value of the split hand sign.

    Conclusions:

    • The split hand symptom is a highly specific indicator for diagnosing amyotrophic lateral sclerosis (ALS).
    • Understanding this symptom's differential muscle involvement is key to identifying potential specific pathological mechanisms in ALS.
    • Early recognition of the split hand symptom can aid in the timely diagnosis and management of ALS.