Clonazepam and botulinum toxin for the treatment of alien limb phenomenon

Neurologist. 2010 Mar;16(2):106-8. doi: 10.1097/NRL.0b013e3181a0d670.

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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

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

Substances

  • Neuromuscular Agents
  • Clonazepam
  • Botulinum Toxins