他人之手症候群：六例報告及文獻回顧

Alien Hand Syndrome：Report of Six Cases and Review of the Literature

曾繁斐(Fan-Fei Tseng) ； 畢柳鶯(Liu-Ing Bih) ； 何啟中(Chi-Chung Ho)

《中華民國復健醫學會雜誌》 28卷2期 (2000/06) Pp. 117-123

https://doi.org/10.6315/JRMA.200006.0117

摘要

本院自民國八十二年至八十七年共收集六位腦中風病人(五位是左側前大腦動脈阻塞，一位是出血性中風合併水腦)，其慣用的右手表現出明顯的抓握反射，對視力所及的物品，會不由自主的抓取，並對身邊的物品出現操弄行為，而對側手則常有制止的動作，甚至抓住患側手，限制其活動，如此不受病人意識控制的患側手，宛如他人之手，因而名之。
近二十年來有許多神經心理學者對此類症候群在文獻上有熱烈的討論，而復健科醫師則較少提出這方面的報告。其實病人在腦部病變或損傷的急性期，由於大腦功能的低落及肢體活動的受限，尚未表現出明顯的症狀，而在接受復健恢復期間，比較容易出現典型的症狀。作者們希望經由本報告引起復健醫療人員對此症候群的注意，以提升其診斷率及治療效果。對這類特殊的行為，我們藉由前人經驗和臨床嘗試，提出一些代償因應的方法，以供復健學界同仁參考。

關鍵字

他人之手症候群 ； 額葉病變 ； 腦中風

並列摘要

The alien hand syndrome was diagnosed in six stroke patients treated in our hospital during the period from 1993 to 1998. Left cerebral artery occlusion was responsible for the stroke episode in five patients and hydrocephalus subsequent to intracerebral hemorrhage in one patient. All of the patients were right handed and exhibited behavior of forced grasping and impulsive groping, with their dominant hand, of objects entering their field of vision. The patients also exhibited unilateral involuntary handling and utilization of familiar objects and compulsive manipulation of tools with their dominant hand and restrain of the dominant hand with their contralateral hand. These patients all showed lack of conscious awareness of these behaviors.
During the acute stage of brain damage in stroke, the reduction in patients’ cerebral function and limitations in the activity of the limbs may obscure the classic symptoms of the alien hand syndrome. However, the symptoms of the alien hand syndrome become more noticeable during the rehabilitation period. This report seeks to call this syndrome to the attention of fellow physiatrists in order to facilitate the use of appropriate measures to handle such special behavior and avoid its interference with patients’ rehabilitation.

並列關鍵字

alien hand syndrome ； frontal lobe lesion ； stroke