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A Wolf in Sheep's Clothing: An "Alien Leg" in Corticobasal Syndrome.

Abstract

BACKGROUND

Alien limb phenomenon occurs in 50-60% of patients with corticobasal syndrome (CBS) and usually presents with an "alien hand" phenomenon. The "alien foot" presentation is rarer and may be misdiagnosed, as foot involvement can lead to erroneous localization of the clinical problem to the knee, hip, or back. Subsequently misdiagnoses such as myelopathy, radiculopathy, functional disorder, stiff leg syndrome, neuromyotonia, and painful leg moving toes syndrome may occur.

CASE REPORT

We describe two patients with alien foot symptoms that resulted in multiple opinions from different specialists, multiple diagnostic and therapeutic procedures, and delayed diagnosis. Eventually a diagnosis of CBS was made in both. Alien foot symptoms may be more common than initially thought and can result in a delayed diagnosis of CBS.

CONCLUSION

The inclusion of this clinical finding in recently proposed diagnostic criteria highlights the need for increased clinical awareness.

Authors+Show Affiliations

Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland.Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland.Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland.Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland.Department of Clinical Neurophysiology, St Vincent's University Hospital, Dublin, Ireland.Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28469972

Citation

Olszewska, Diana Angelika, et al. "A Wolf in Sheep's Clothing: an "Alien Leg" in Corticobasal Syndrome." Tremor and Other Hyperkinetic Movements (New York, N.Y.), vol. 7, 2017, p. 455.
Olszewska DA, McCarthy A, Murray B, et al. A Wolf in Sheep's Clothing: An "Alien Leg" in Corticobasal Syndrome. Tremor Other Hyperkinet Mov (N Y). 2017;7:455.
Olszewska, D. A., McCarthy, A., Murray, B., Magennis, B., Connolly, S., & Lynch, T. (2017). A Wolf in Sheep's Clothing: An "Alien Leg" in Corticobasal Syndrome. Tremor and Other Hyperkinetic Movements (New York, N.Y.), 7, p. 455. doi:10.7916/D86D5ZT8.
Olszewska DA, et al. A Wolf in Sheep's Clothing: an "Alien Leg" in Corticobasal Syndrome. Tremor Other Hyperkinet Mov (N Y). 2017;7:455. PubMed PMID: 28469972.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Wolf in Sheep's Clothing: An "Alien Leg" in Corticobasal Syndrome. AU - Olszewska,Diana Angelika, AU - McCarthy,Allan, AU - Murray,Brian, AU - Magennis,Brian, AU - Connolly,Sean, AU - Lynch,Tim, Y1 - 2017/04/26/ PY - 2017/02/17/received PY - 2017/03/31/accepted PY - 2017/5/5/entrez PY - 2017/5/5/pubmed PY - 2017/5/5/medline KW - Alien limb KW - alien leg KW - corticobasal syndrome SP - 455 EP - 455 JF - Tremor and other hyperkinetic movements (New York, N.Y.) JO - Tremor Other Hyperkinet Mov (N Y) VL - 7 N2 - BACKGROUND: Alien limb phenomenon occurs in 50-60% of patients with corticobasal syndrome (CBS) and usually presents with an "alien hand" phenomenon. The "alien foot" presentation is rarer and may be misdiagnosed, as foot involvement can lead to erroneous localization of the clinical problem to the knee, hip, or back. Subsequently misdiagnoses such as myelopathy, radiculopathy, functional disorder, stiff leg syndrome, neuromyotonia, and painful leg moving toes syndrome may occur. CASE REPORT: We describe two patients with alien foot symptoms that resulted in multiple opinions from different specialists, multiple diagnostic and therapeutic procedures, and delayed diagnosis. Eventually a diagnosis of CBS was made in both. Alien foot symptoms may be more common than initially thought and can result in a delayed diagnosis of CBS. CONCLUSION: The inclusion of this clinical finding in recently proposed diagnostic criteria highlights the need for increased clinical awareness. SN - 2160-8288 UR - https://www.unboundmedicine.com/medline/citation/28469972/A_Wolf_in_Sheep's_Clothing:_An_"Alien_Leg"_in_Corticobasal_Syndrome L2 - http://dx.doi.org/doi:10.7916/D86D5ZT8 DB - PRIME DP - Unbound Medicine ER -