Alien hand syndrome!

[bandas]

Anyone dealt or heard of "alien hand syndrome"? Had a patient post-stroke that has this and I wouldn't have believed it unless I saw it. Her hand was like it was possessed. It had a "mind of its own". Her hand has now become known as "THE HAND" to her, as in "help me, THE HAND keeps touching me". She has completely depersonalized her hand. She kept hitting herself in the face repetitively, hard, and nearly broke her glasses. Also ended up bloodying her knuckles from hitting things. The worst part was when she grabbed her good hand with the bad hand and when she tried to pull her good hand out of her bad hand's grasp it ripped all of her skin off her hand. The hand has also tried to rip out her IV and midline.

We all had to do some research on the internet once the neurologist told us what was going on. I just feel bad for her because she can't control it and its scaring her. It doesn't help that its being so mean to her! I've read that it is quite rare. It also depends on where the stroke was at on what abilities the hand has, such as flailing, grasping, pinching, or movements that seem even more purposeful. Wondering if anyone has any stories for me on this topic?

[rkitty198, BSN, RN]

Wow how intresting! I have never heard of that. This one patient I had, after his stroke he was able to spell and count backwards, even talk backwards.

Poor lady, how scary it must be for her!

[bandas]

Yeah, we really thought at first that it was a psych issue. This was before the stroke was found. Someone came out of the room and said "that poor lady is crazy...she just pulled all the skin off her own hand!

[cebollita]

Wow, sounds like a Bruce Campell movie.

[suanna]

Have heard of it- my aunt had a simular relationship with her hand after her stroke- it was just much better behaved. Her chief complaint was that someone kept putting thier arm in bed with her.... My heart goes out to your poor lady- please

re-post if you learn the outcome of this poor souls rehab. How frightening it must be for her.

[merlee]

I once took care of a patient who just couldn't seem to get the idea that the right side of his body was weakened - he just ignored it and kept falling.

The brain is so complex, isn't it?

[nursej22, MSN, RN]

I cared for a patient who was being treated on our cardiac tele unit for subacute endocarditis from an unknown source. He also had brain abscesses (apparently related to the endocarditis) resulting in stroke-like symptoms. When he would fall asleep one of his arms would rise straight up over his head and his hand would slowly wave in the air. The neurologist treated it with Keppra.

[shhhh]

Wow, sounds like a Bruce Campell movie.

Bwahahhaha! Not laughing at this poor woman, but rather what cebollita said! My husband, brother, and father live to watch all those movies Bruce Campbell has made, so I totally know was cebollita is talking about.

But seriously, what bandas patient's going through sounds awful and I couldn't imagine dealing with it myself. I never had a patient who had this, but I did have a patient who suffered a stroke, and afterwards, the entire right half of his body constantly moved spastically. His right arm and right leg flailed violently to the point where he begged that we restrain him. And even then, we padded his bed rail with seizure pads because he'd break through the restraints. It was right after I graduated nursing school, so I can't really remember what the neurologist's plan of treatment was for him, but after reading nursej22's post, I want to say that Keppra really sounds familiar and that's what he gave him and it was a bit helpful.

I had another patient who was psychologically disturbed instead of having a neurological event. He'd stare at you for what seemed like forever and then quicker than I don't know what, he'd snarl like a dog and start chewing on his own hand! We caught onto to it really quick and tried out best to stop him before he really hurt himself, but it was so difficult. He had been doing this for years, and not only did this poor kid CHEW the skin off his hand, he actually succeeded in chewing his fingers off slowly! I'm so sorry if I grossed anyone out, but this post reminded me of it!

[Flare, ASN, BSN]

i wonder if placing the bad hand in a mitten would help.

[BluegrassRN]

Yes, I've seen this. My patient's "alien hand" would wander around her face and body, picking at her lips (and food, if she was eating), running through her hair, knocking off her glasses. That stupid hand just would not leave her alone; she hated it. She said it really was as if someone were standing there, constantly touching her, rather than her own hand. It was horribly annoying and distracting for her.

We finally restrained it (at her request). When in bed or in the chair we used a soft limb restraint. When she was up walking around, we'd wrap the hand in ace bandages and put the entire arm in a sling, as if she had a broken arm. That would usually keep the hand quiet.

[catlvr]

One of our dearest patients has cortical basal ganglionic degeneration, and a phantom hand. Since the phantom hand is the only one that works (paralyzed on the other side), it is especially tragic. The hand waves in the air, gets in the way of feeding and other care, and generally drives her nuts. Fortunately, it isn't an "evil" hand - hasn't tried to hurt her. But she was an RN for 40 years and is such a nice lady that it really is sad. She's got most of her wits about her and can see her decline.

[FutureNurse_8708]

I have never heard of anything like this and it is so interesting! I looked it up and was just amazed at what our body does to us when things aren't connected right. I am so sorry that people are going through this kind of thing. I hope someone comes up with a cure soon.