Intermittent alien hand syndrome caused by Marchiafava-Bignami disease: A case report

Medicine (Baltimore). 2019 Aug;98(34):e16891. doi: 10.1097/MD.0000000000016891.

Abstract

Rationale: Alien Hand syndrome (AHS) is characterized in most patients by seemingly purposeful, involuntary movements of the extremities. It is not well known among physicians on account of its diverse clinical manifestations.

Patient concerns: We present a 57-year-old Chinese man who could not stop or turn himself around as he involuntarily and uncontrollably walked forward, which had happened frequently in the month prior to treatment. He had been a heavy drinker for thirty years before the onset of the disease, with an alcohol intake of 600 to 800 ml/day.

Diagnoses: History of alcohol intake and the brain magnetic resonance imaging findings indicated a diagnosis of Marchiafava-Bignami disease. The patient was additionally diagnosed with Alien Hand Syndrome according to his clinical symptoms.

Interventions: The patient was treated with high doses of vitamin B for 1 month.

Outcomes: The patient's abnormal behaviors never appeared during the treatment, and no instance of recurrence was observed during the 6 months of follow-up.

Lessons: The clinical manifestation of AHS is non-specific. Only by considering its diverse manifestation can doctors better understand the disease and achieve early intervention.

Publication types

  • Case Reports

MeSH terms

  • Alcoholism / complications
  • Alien Limb Phenomenon / diagnosis
  • Alien Limb Phenomenon / etiology*
  • Corpus Callosum / diagnostic imaging
  • Corpus Callosum / pathology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Marchiafava-Bignami Disease / complications*
  • Marchiafava-Bignami Disease / diagnosis*
  • Marchiafava-Bignami Disease / drug therapy
  • Middle Aged
  • Thiamine / therapeutic use
  • Vitamin B Complex / therapeutic use

Substances

  • Vitamin B Complex
  • Thiamine