Clonazepam and botulinum toxin for the treatment of alien limb phenomenon.

Abstract

We discuss a patient who developed an "alien limb" on her right side after brain herniation. She reported feeling as though her arm movements were controlled by a stranger and displayed limb levitation and groping behaviors. She received 0.5 mg clonazepam b.i.d. This was followed by a limb levitation frequency reduction of 73%. Discontinuation and retrial of clonazepam verified this response. She suffered a psychotic episode that she attributed to clonazepam. Clonazepam was discontinued. She received botulinum toxin injections to her arm that reduced her limb levitation by 84%. This is the first report of response to medication in alien limb syndrome.

• Authors: Ihtsham U Haq, Irene A Malaty, Michael S Okun, Charles E Jacobson, Hubert H Fernandez, Ramon R Rodriguez
• Journal: The neurologist (Neurologist) Vol. 16 Issue 2 Pg. 106-8 (Mar 2010) ISSN: 2331-2637 [Electronic] United States
• PMID: 20220444 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Neuromuscular Agents
• Clonazepam
• Botulinum Toxins

Topics

• Adolescent
• Alien Limb Phenomenon (drug therapy, pathology)
• Botulinum Toxins (therapeutic use)
• Brain (pathology)
• Clonazepam (adverse effects, therapeutic use)
• Female
• Humans
• Magnetic Resonance Imaging
• Mental Disorders (chemically induced)
• Neuromuscular Agents (adverse effects, therapeutic use)
• Treatment Outcome