Alien hand syndrome in the context of "Corticobasal degeneration"

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⭐ Core Definition: Alien hand syndrome

Alien hand syndrome (AHS) or Dr. Strangelove syndrome is a category of conditions in which a person experiences their limbs acting seemingly on their own, without conscious control over the actions. There are a variety of clinical conditions that fall under this category, most commonly affecting the left hand. There are many similar terms for the various forms of the condition, but they are often used inappropriately. The affected person may sometimes reach for objects and manipulate them without wanting to do so, even to the point of having to use the controllable hand to restrain the alien hand. The occurrence of alien hand syndrome can be usefully conceptualized as a phenomenon reflecting a functional "disentanglement" between thought and action.

Alien hand syndrome is best documented in cases where a person has had the two hemispheres of their brain surgically separated, a procedure sometimes used to relieve the symptoms of extreme cases of epilepsy and epileptic psychosis, e.g., temporal lobe epilepsy. It also occurs in some cases after brain surgery, stroke, infection, tumor, aneurysm, migraine and specific degenerative brain conditions such as Alzheimer's disease, corticobasal degeneration and Creutzfeldt–Jakob disease. Other areas of the brain that are associated with alien hand syndrome are the frontal, occipital, and parietal lobes.

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Alien hand syndrome in the context of Split-brain

Split-brain or callosal syndrome is a type of disconnection syndrome when the corpus callosum connecting the two hemispheres of the brain is severed to some degree. It is an association of symptoms produced by disruption of, or interference with, the connection between the hemispheres of the brain. The surgical operation to produce this condition (corpus callosotomy) involves transection of the corpus callosum, and is usually a last resort to treat refractory epilepsy. Initially, partial callosotomies are performed; if this operation does not succeed, a complete callosotomy is performed to mitigate the risk of accidental physical injury by reducing the severity and violence of epileptic seizures. Before using callosotomies, epilepsy is instead treated through pharmaceutical means. After surgery, neuropsychological assessments are often performed.

After the right and left brain are separated, each hemisphere will have its own separate perception, concepts, and impulses to act. Having two "brains" in one body can create some interesting dilemmas. There was a case in which, when one split-brain patient would dress himself, sometimes he pulled his pants up with one hand (the side of his brain that wanted to get dressed) and down with the other (the side that did not). He was also reported to have grabbed his wife with his left hand and shook her violently, at which point his right hand came to her aid and grabbed the aggressive left hand (a phenomenon sometimes occurring, known as alien hand syndrome). However, such conflicts are very rare. If a conflict arises, one hemisphere usually overrides the other.

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Alien hand syndrome in the context of Corpus callosotomy

A corpus callosotomy (/kəˈlɔːs(ə)təm/) is a palliative surgical procedure for the treatment of medically refractory epilepsy. The procedure was first performed in 1940 by William P. van Wagenen. In this procedure, the corpus callosum is cut through, in an effort to limit the spread of epileptic activity between the two halves of the brain.

Although the corpus callosum is the largest white matter tract connecting the hemispheres, some limited interhemispheric communication is still possible via the anterior and posterior commissures. After the operation, however, the brain often struggles to send messages between hemispheres, which can lead to side effects such as speech irregularities, disconnection syndrome, and alien hand syndrome.

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