PubMed Health⌕ Search

PubMed · 1775229

Right-sided anarchic (alien) hand: a longitudinal study.

Abstract

A patient with a bilateral frontal vascular lesion, encroaching upon the mesial cortex on the left and damage of the corpus callosum showed the 'alien hand' phenomenon on the right. The various hypotheses as to the nature of the lesion for the alien hand phenomenon to appear are discussed. It is proposed that an acute clinical condition, following a lesion of the corpus callosum only, should be differentiated from a chronic condition resulting from the additional fronto-mesial lesion.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

S Della Sala, C Marchetti, H Spinnler. 1991. Right-sided anarchic (alien) hand: a longitudinal study.. https://doi.org/10.1016/0028-3932(91)90081-i

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Patterns of hand motion during grasping and the influence of sensory guidance.

This study was aimed at describing temporal synergies of hand movement and determining the influence of sensory cues on the control of these synergies. Subjects were asked to reach to and grasp various objects under three experimental conditions: (1) memory-guided movements, in which the object was not in view during the movement; (2) virtual object, in which a virtual image of the object was in view but the object was not physically present; and (3) real object, in which the object was in view and physically present. Motion of the arm and of 15 degrees of freedom of the hand was recorded. A principal components analysis was developed to provide a concise description of the spatiotemporal patterns underlying the motion. Vision of the object during the reaching movement had no influence on the kinematics, and the effect of the physical presence of the object became manifest primarily after the fingers had contacted the object. Two principal components accounted for >75% of the variance. For both components, there was a strong positive correlation in the rotations of metacarpophalangeal and proximal interphalangeal joints of the fingers. The first principal component exhibited a pattern of finger extension reversing to flexion, whereas the second principal component became important only in the second half of the reaching movement.

Arm↗

[Critical ischaemia of the limbs and localized livedo in a case of ergotism].

HISTORY AND ADMISSION FINDINGS: A 57-year-old woman, a heavy smoker and migraine sufferer, was admitted with severe resting pain in the right forefoot and painful localized tendril-shaped reddening on the right thigh. She had regularly been taking 1-2 mg ergotamine tartrate, several analgesics, some containing caffeine, and selective serotonin-uptake inhibitors. Clinical examination found all limbs to be cool. On the right leg the pulse was not palpable below the inguinal line, and the reddening corresponded to localized livedo. INVESTIGATIONS: The peripheral Doppler pressure indicated critical perfusion reduction in the right leg with a tibiobrachial pressure ratio of 0.14. Colour-coded duplex sonography showed generalized vasoconstriction with filiform hourglass stenosis of the right proximal superficial femoral artery without atherosclerotic changes. The history of drug intake and the characteristic sonographic findings indicated ergotism and an arteriography was deemed unnecessary. TREATMENT AND COURSE: All ergotamine and caffeine containing drugs were discontinued and the patient urged to stop smoking. Amlidopine, 2.5 mg orally, and prostaglandin E1, 60 microgram i.v., were administered daily. The resting pain was much reduced after the first infusion and the painful livedo disappeared. The documented high-grade stenosis of the right superficial femoral artery was reduced to 25-50% by the third day of infusion. At the end of 10 daily infusions both the Doppler pressure and the duplex sonography had become normal. Pizotifen was given for the migraine and the serotonin re-uptake inhibitor sertralin was discontinued. CONCLUSION: An interaction of the serotonin re-uptake inhibitor with ergotamine was presumably responsible for the development of ergotism under >>therapeutic<< ergotamine dosage. Vasospastic stenoses and occlusions can be demonstrated by duplex sonography and may in future not require additional angiographic confirmation. Intravenous rather than intraarterial infusion of prostaglandin is to be preferred if vessels at many sites are affected. Livedo is a transitory sign of ergotism.

Arm↗

The Spurling test and cervical radiculopathy.

STUDY DESIGN: A cross-sectional study design was used. OBJECTIVE: To determine the sensitivity and specificity of the Spurling test for cervical radiculopathy. SUMMARY OF BACKGROUND DATA: The Spurling test is an accepted physical examination test, but there is little data on its sensitivity or specificity. METHODS: From 1988 to 1993, 255 consecutive patients were referred for electrodiagnosis of upper extremity nerve disorders. A Spurling test administered before other testing was performed. The Spurling test was scored as positive if it caused pain or tingling that started in the shoulder and radiated distally to the elbow. After the electrodiagnostic examination, a score was given to each diagnosis in the differential diagnosis according to the likelihood of its presence. To determine the odds ratio, sensitivity, and specificity, chi2 analysis was used. Also, the percentage of subjects with positive results from the Spurling test was calculated for several nerve disease diagnoses. RESULTS: The Spurling test had a sensitivity of 6/20 (30%) and a specificity of 160/172 (93%). The results were positive in 16.6% of the normal group, in 3.4% of the group with nerve disorders other than a radiculopathy, in 25% of the group with an abnormality not consistent with any specific diagnosis group, in 37.5% of the group with possible radiculopathy, and in 40% of the group with certain radiculopathy. CONCLUSIONS: The Spurling test is not very sensitive, but it is specific for cervical radiculopathy diagnosed by electromyography. Therefore, it is not useful as a screening test, but it is clinically useful in helping to confirm a cervical radiculopathy.

Arm↗