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.