The Alien Hand Syndrome (AHS) is a phenomenon characterized by involuntary autonomous activity of the affected extremity, perceived by the patient as controlled by an external force. It may result from a number of conditions including brain injury, stroke, tumors and progressive neurological disorders. The syndrome was first described in 1908 by Kurt Goldstein.
A case of AHS in a 60 year old right handed gentleman admitted with a subarachnoid haemorrhage secondary to a pericallosal aneurysm has been studied. He developed involuntary movement of his right hand including excessive grasp reflex and intermanual conflict. He was noted to make good progress throughout his rehabilitation and by time of discharge his Alien Hand movements were diminished and interfering less in activity performance. During this stage remedial and neurodevelopmental approaches were employed. Remedial approaches included strengthening the extensor musculature, increasing range of movement, perceptual retraining and desensitisation of the right hand. Neurodevelopmental approaches included weight bearing activities, trunk rotation activities, facilitation of slow and controlled movements and guided movements facilitated by the therapist when completing tasks. Early recognition of patients who present with AHS will allow the multi-disciplinary rehabilitation team to set goals and tailor the rehabilitation approach to target the functional limitations caused by this condition. With appropriate rehabilitation input, significant improvement can be expected in patients with AHS.