Abstract

Dr James Rowe, Consultant Neurologist BA (Cantab) BM BCh (Oxon) PhD (Lond) CCST FRCP (Lond)​

I lead regional specialist clinics for patients and carers with dementia, including frontotemporal dementia (also called Picks disease, Semantic dementia and Primary progressive aphasia), Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD), and the Cambridge Memory Clinic supporting people with mild cognitive impairment and Alzheimers disease.

These clinics are supported by a dedicated team of doctors, nurses, psychologists and scientists, providing the very highest standards of care for patients and families, as well as advising community services and general practitioners. The clinics aim to help in accurate diagnosis, investigations, treatment and support throughout. We also offer many opportunities to take part in our internationally recognised research programs.

The alien limb is a favourite theme of Hollywood films, but the reality of this enigmatic neurological phenomena is very different from its cinematic portrayal.

Here we review the clinical phenomena and try to bring order to the often confusing and conflicting nomenclature of the last 100 years. We place the alien hand in a broader framework of voluntary control and agency, providing new psychological paradigms and computational methods to understand the disorder.

Brain imaging has also provided new insights into the functional anatomy of disorders of agency.

We identify goals for future research and clinical practice: to clarify the clinical phenomenology and operationalisation of alien limb; to determine how action awareness is altered by neurological disease; and to use this knowledge to guide better treatment for patients affected by alien limb.