The alien hand sign
A 45-year-old man was brought by his wife with complaints of slow speech for the previous 5 days. He was a diabetic on irregular therapy. The patient informed that his right hand was grabbing objects without his control and he was using his left hand to control the right hand. He used to keep his right hand below his pillow to control it. He also stated that his right hand used to grab his genitals involuntarily, even in public places, often to his embarrassment and that of his wife.\nHis vital signs were normal. On the right side of body, power was 4+/5 with brisk reflexes, extensor plantar response, palmomental reflex, and exaggerated grasp reflex without any sensory loss. He could not release the right hand without the help of the left hand. Common, usual objects were kept in front of him and he was instructed not to touch them. However, his right hand (affected limb) reached for these objects but the left hand (normal limb) immediately removed these objects from the right hand []. He used the left hand to control his right hand even when at rest.\nPlain computed tomography showed a sub-acute infarct in the left anterior cerebral artery involving the left medial frontal lobe and anterior corpus callosum, which was confirmed by magnetic resonance imaging [Figures and ]. A final diagnosis of frontal variant of AHS was made. He was discharged and was advised medication with aspirin, metformin and atorvastatin. Two months later, although these abnormal movements diminished in intensity, they persisted.