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Behavioural Neurology
Volume 2014, Article ID 873541, 7 pages
Case Report

Intermittent Alien Hand Syndrome and Callosal Apraxia in Multiple Sclerosis: Implications for Interhemispheric Communication

1Rehabilitation Medicine, Ospedali Riuniti, Trieste, Italy
2Department of Medical Sciences, University of Trieste, Italy
3Neuroscience Area, SISSA, Trieste, Italy

Received 3 March 2013; Accepted 10 September 2013; Published 18 February 2014

Academic Editor: Stefano F. Cappa

Copyright © 2014 A. Lunardelli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We report a case of a 47-year-old woman with 35-year history of multiple sclerosis, who showed alien hand signs, a rare behavioural disorder that involves unilateral goal-directed movements that are contrary to the individual's intention. Alien hand syndrome has been described in multiple sclerosis (MS) only occasionally and is generally suggestive of callosal disconnection. The patient presented also with bilateral limb apraxia and left hand agraphia, raising the possibility of cortical dysfunction or disconnection, in addition to corpus callosum and white matter involvement. Her specific pattern of symptoms supports the role of the corpus callosum in interhemispheric communication for complex as well as fine motor activities and may indicate that it can serve as both an inhibitory and excitatory function depending on task demands.