LEG MANIFESTATION IN ALIEN HAND SYNDROME

A patient with left alien hand syndrome (AHS) accompanied by leg sympt oms due to right anterior cerebral artery territory infarction is repo rted. Magnetic resonance imaging demonstrated that the responsible les ion involved the right anterior cingulate gyrus, supplementary motor a rea, medial prefrontal cortex and corpus callosum extending from the g enu to the isthmus. The leg symptoms included: 1) motor perseveration manifesting as compulsive straight walking with difficulty stopping on command; 2) dissociation between mind and action resulting in going t o unintended places with subsequent complaints of poor memory not due to spatial disorientationl 3) discrepancy between verbal and actual le g motor responses to auditory verbal suggestions; and 4) movement diss ociation between the legs resulting in transient standing still or bri ef sticking to the ground, a situation simulating akinesia. As the leg s usually perform together to coordinate movements of standing and wal king, unlike the hands performing well-learned, skilled unimanual or b imanual coordinating movements, the counterpart in the leg of the alie n hand sign in AHS was not manifested. Nevertheless, in the presence o f AHS, the associated leg symptoms bear similar neurobehavioral featur es and should he dealt with on equal terms.