Abstract

previously independent 54-year-old ambidextrous male presented to the hospital with frequent syncopal episodes and chest pain and was diagnosed with subclavian steal syndrome. After undergoing subclavian stent placement, he was found to have left hemineglect, and imaging revealed a right parietal infarction. After subsequently displaying involuntary arm movements including levitation and fist clenching, the patient was diagnosed with the rare posterior variant of Alien Hand Syndrome upon admission to inpatient rehabilitation. Based on anecdotal efficacy described in a few case reports, clonazepam was started alongside therapy techniques, including compensatory distraction methods, mirror therapy, verbal cueing, and visual feedback. The patient demonstrated improvement over the course of his 16 days stay in inpatient rehabilitation, as evidenced by patient-reporting, an increase in functional independence measure from 49/126 to 80/126, and an improvement by 15 points on the Scale for Assessment and Rating of Ataxia (SARA) for the left hand. This case report aims to use available literature to highlight an uncommon debilitating condition, detail diagnostic and assessment tools, and discuss treatment options