Alien hand syndrome in AIDS: Neuropsychological features and physiopathological considerations based on a case report

Area of Science:

• Neurology
• Infectious Diseases

Background:

• Alien hand syndrome (AHS) is characterized by involuntary, purposeful limb movements and a sense of foreignness.
• It often involves a failure to recognize limb ownership without visual cues.

Observation:

• A 41-year-old, HIV-positive, left-handed woman presented with loss of voluntary control over her left hand.
• She exhibited uncommanded, extraneous movements, such as groping objects, and reported talking to or fighting her hand.
• Associated symptoms included recent memory loss, hemineglect, and dysphoria.

Findings:

• Computed tomography revealed a right frontal-parietal hypodensity with midline deviation.
• Clinical and epidemiological data led to a diagnosis of Central Nervous System (CNS) toxoplasmosis.
• This represents a novel reported association between Acquired Immunodeficiency Syndrome (AIDS), toxoplasmosis, and AHS.

Implications:

• This case expands the known neurological manifestations of CNS toxoplasmosis in HIV-positive individuals.
• It underscores the importance of considering infectious etiologies in complex neurological presentations.
• Further research may elucidate the specific mechanisms linking these conditions.