Nosology and terms associated with "alien hand syndrome"

taken from Biran I, Chatterjee A. Alien hand syndrome, Arch Neurol 61:292-294, 2004

Categories--3 broad
1) terms implying a conflict of will of hands or opposition of one hand to other (intermanual conflict, diagonistic apraxia, agonistic apraxia)
2) terms implying aberrant movements, stimulus boundedness of hands (compulsive manipulation of tools, anarchic hand, magnetic apraxia)
3) terms describing the subjective reaction to limb (autocriticism, interhemspheric autocriticism, strange hand sign)

original credit for "la main etrangere" Brion and Jedynak, 1972(rev Neurologie (Paris) 126:257-266, describing patients with callosotomy

first revision Wilson et al.Neurology 1977 27:708-715 to "the stranger's hand sign" leading to Bogen's "Alien hand"(se 3rd edition Heilman and Valenstein).

Historically descriptions of the syndrome previously were described by Liepmann ad Goldstein. Akelaitis introduced "diagonistic dyspraxia" in 1940s. Gazzaniga , Bogen and Sperry wrote about it in 1962 in split brain patients. Rebeiz wrote about it in his eponymic syndrome, also called corticobasal ganglionic degeneration, in his seminal article in the late 1960s. Patients with this condition would be more likely to have type 2 above.


Denny-Brown described "repellant" and"magnetic" apraxia in patients with parietal and frontal lesions, and explained them in terms of approach and avoidance behaviors. Magnetic apraxia involves compulsive grasping, repellant apraxia may involve levitation and hyperextension of wrist showing an exaggerated posture.