Alien Limb Phenomenon as a Heralding Manifestation of Toxic Leukoencephalopathy
Abstract
Alien limb phenomenon (ALP) is an intriguing entity characterised by involuntary movements of the limb along with a sense of estrangement. Corticobasal degeneration is the most common cause of ALP followed by other etiologies such as stroke, Creutzfeldt–Jakob disease (CJD). Toxin-induced leukoencephalopathy has not been reported as an aetiology of ALP. We report the case of a 41-year-old gentleman who presented with ALP as a manifestation of toxic leukoencephalopathy caused due to mesalazine. A 41-year-old right-handed male with history of ulcerative colitis developed an exacerbation of the disease and was managed with steroids and mesalazine. The dosage was hiked up to 2.4 grams from a stable dose of 800 mg/day. After 15 days of increase in the dosage of mesalazine, patient developed difficulty in understanding spoken language along with increasing difficulty in using his right hand. He complained that his hand was not letting him comb his hair or “disturbing” him when he tried to eat an apple with his left hand. He, however, did not report any motor weakness in both the upper limbs and could hold objects equally well with both hands. He also had two episodes of generalised tonic–clonic seizures after which he was brought to the emergency services of our hospital. On examination, patient was conscious but not responding to verbal command, although on giving painful stimuli he withdrew his upper limb from the painful stimuli. There were no cranial nerve deficits. Motor…
Read the paper
Related studies
- The neurocircuitry of addiction: an overview
- Gender Differences in Human Brain: A Review
- Stratified medicine for mental disorders
- The neurobiology of drug addiction: cross-species insights into the dysfunction and recovery of the prefrontal cortex
- Annual Research Review: DNA methylation as a mediator in the association between risk exposure and child and adolescent psychopathology
- Schizophrenia: The new etiological synthesis
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.