{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:57:26Z","timestamp":1777694246613,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Case Rep"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>Alien Hand Syndrome (AHS) is a rare neurological condition characterized by involuntary, goal-directed movements of a limb without conscious control. It is most often associated with stroke in specific brain regions, including the medial frontal and parietal cortices. We report the case of a 33-year-old male with no previous medical history who presented with involuntary movements of the left upper limb, describing it as \u201cmoving on its own.\u201d Neurological examination was unremarkable, but MRI revealed multiple cortical infarcts in the right frontal and parietal lobes, with both acute and subacute features. Extensive workup ruled out vascular stenosis, dissection, and hypercoagulable states. Transthoracic echocardiography showed normal left ventricular function and a hypermobile interatrial septum. Transesophageal echocardiography confirmed the presence of a tunnel-shaped patent foramen ovale (PFO; 0.4\u2009mm\u2009\u00d7\u20090.3\u2009mm) without thrombus. No deep vein thrombosis or other embolic sources were found. A diagnosis of cardioembolic stroke due to paradoxical embolism through a PFO was established. The patient underwent successful percutaneous closure and started dual antiplatelet therapy. At follow-up, AHS symptoms improved significantly. This case highlights an atypical initial presentation of ischemic stroke in a young adult and emphasizes the need for early neuroimaging and comprehensive cardiac evaluation in cryptogenic strokes.<\/jats:p>","DOI":"10.1177\/11795476251362059","type":"journal-article","created":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T06:16:03Z","timestamp":1755238563000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Alien Hand Syndrome as the Initial Presentation of Patent Foramen Ovale-Associated Stroke"],"prefix":"10.1177","volume":"18","author":[{"given":"Drixie D.","family":"Vargas","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Fundaci\u00f3n Santa Fe de Bogot\u00e1, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny M.","family":"Garz\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Fundaci\u00f3n Santa Fe de Bogot\u00e1, Colombia"},{"name":"School of Medicine Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1542-0249","authenticated-orcid":false,"given":"Mar\u00eda Cristina","family":"Mart\u00ednez-\u00c1vila","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Fundaci\u00f3n Santa Fe de Bogot\u00e1, Colombia"},{"name":"School of Medicine Universidad El Bosque, Bogot\u00e1, Colombia"},{"name":"Epidemiology and Public Health, Universidad de Ciencias M\u00e9dicas, Managua, Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan D.","family":"H. Zuluaga","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Fundaci\u00f3n Santa Fe de Bogot\u00e1, Colombia"},{"name":"Epidemiology and Public Health, Universidad de Ciencias M\u00e9dicas, Managua, Nicaragua"},{"name":"School of Medicine Universidad de los Andes, Bogot\u00e1, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Sotelo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Fundaci\u00f3n Santa Fe de Bogot\u00e1, Colombia"},{"name":"School of Medicine Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2006.02.002"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.7916\/D8VX0F48"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.9-5-466"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.3166"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-016-0676-z"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/20009666.2020.1756610"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2014.11929115"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtumed.2020.12.003"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0015010"},{"issue":"5","key":"e_1_3_3_11_2","article-title":"Alien hand syndrome in a young adult: a rare presentation of ischemic stroke","volume":"28","author":"McNabb CB","year":"2019","unstructured":"McNabb CB, Carroll E, Huddleston L, et al. Alien hand syndrome in a young adult: a rare presentation of ischemic stroke. J Stroke Cerebrovasc Dis. 2019;28(5):e58-e60.","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"e_1_3_3_12_2","first-page":"107140","article-title":"Alien hand syndrome following acute parietal stroke: a case series and review of the literature","volume":"229","author":"Nahas M","year":"2024","unstructured":"Nahas M, El Atrouni W, Abu-Ghanem S, et al. Alien hand syndrome following acute parietal stroke: a case series and review of the literature. Clin Neurol Neurosurg. 2024;229:107140.","journal-title":"Clin Neurol Neurosurg"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707404"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1705915"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1610057"}],"container-title":["Clinical Medicine Insights: Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795476251362059","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11795476251362059","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795476251362059","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:14:44Z","timestamp":1777454084000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11795476251362059"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":14,"alternative-id":["10.1177\/11795476251362059"],"URL":"https:\/\/doi.org\/10.1177\/11795476251362059","relation":{},"ISSN":["1179-5476","1179-5476"],"issn-type":[{"value":"1179-5476","type":"print"},{"value":"1179-5476","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"article-number":"11795476251362059"}}