Alien Limb Syndrome on Physical Exam



Elderly lady with Parkinsonism (PSP) c/o left leg rising up spontaneously when she sits and prays. She has to consciously force it back down ↓ Mild elevation of left leg.

Alien hand >>> leg. Left right sided limb involvement ratio 73:27%

Simplified; 3 types of Alien limb phenomenon:

1) Anterior ‘Frontal’ Motor type- abnormal movements occur without the patient initiating or controlling it

2 )Posterior, Parietal “sensory” type-a subjective feeling that the hand does not belong to them and is foreign

3) Midline ‘Callosal’ type, Conflict type- where one hand interferes with movements of the contralateral hand



Dr. Boby Varkey Maramattom @bobvarkey



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