Late Detection of Corpus Callosum Infarction in a 55-Year-Old: Insights from Alien Hand Syndrome

BACKGROUND Alien hand syndrome by corpus callous infarction is known although rare. However, it can lead to a delay in diagnosis, as it is an unusual sign of stroke. We report a case of alien hand syndrome that belatedly revealed a corpus callous infarct in an Ivorian man in sub-Saharan Africa. CASE REPORT A 55-year-old patient who was right-handed consulted a neurologist for episodes of inter-manual conflict due to uncontrolled movements of his left hand. This symptomatology had been developing for 8 days and was preceded by a sudden numbness of the left upper limb that had occurred 6 days earlier. The patient was anxious and feared the persistence of these movements. Brain magnetic resonance imaging prescribed by the neurologist allowed the diagnosis of callous body infarctus. The etiological investigation did not find an obvious etiology. Treatment consisted of an anti-diabetic drug, antihypertensive drug, platelet anti-aggregator, statin, and anxiolytic. This symptom had significantly regressed after 21 days. CONCLUSIONS This was alien hand syndrome of diagonal dyspraxia type (inter-manual conflict) associated with cerebral infarction. By updating this syndrome, we hope to attract the attention of physicians to avoid any delay in diagnosis. We recommend brain imaging in case of an unusual clinical manifestation or the prompt referral of the patient to a neurologist.