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Split-hand and split-limb phenomena in amyotrophic lateral sclerosis: pathophysiology, electrophysiology and clinical manifestations

Abstract : Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder affecting the upper and lower motor neurons. A key clinical feature of ALS is the absence of accurate, early-stage diagnostic indicators. ‘Split-hand syndrome’ was first described in ALS at the end of the last century and a considerable body of literature suggests that the split-hand phenomenon may be an important clinical feature of ALS. Considering the published investigations, it is conceivable that the ‘split-hand syndrome’ results from the associated upper and lower motor neuron degeneration, whose interaction remains to be fully clarified. Additionally, other split syndromes have been described in ALS involving upper or lower limbs, with a nuanced description of clinical and neurophysiological manifestations that may further aid ALS diagnosis. In this review, we endeavour to systematically present the spectrum of the ‘split syndromes’ in ALS from a clinical and neurophysiology perspective and discuss their diagnostic and pathogenic utility.
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https://hal-unilim.archives-ouvertes.fr/hal-03350850
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Soumis le : mardi 21 septembre 2021 - 15:58:30
Dernière modification le : mardi 19 octobre 2021 - 11:19:19

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Philippe Corcia, Peter Bede, Pierre-François Pradat, Philippe Couratier, Steve Vucic, et al.. Split-hand and split-limb phenomena in amyotrophic lateral sclerosis: pathophysiology, electrophysiology and clinical manifestations. Journal of Neurology, Neurosurgery and Psychiatry, BMJ Publishing Group, 2021, 92 (10), pp.1126-1130. ⟨10.1136/jnnp-2021-326266⟩. ⟨hal-03350850⟩

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