Algunas disciplinas de la ciencia médica, especialmente la neurología, presentan muchas casuísticas interesantes y asombrosas. Como tal, el cerebro es uno de los órganos más complejos del cuerpo humano y todavía esconde muchas particularidades que esperan ser descubiertas. Tanto la mente consciente como el subconsciente son grandes misterios de la medicina y la psicología. Un sinfín de conexiones infinitas a las que aún no tenemos completo acceso y cuyo análisis atrae a cada vez más especialistas. En este sentido, existen muchas anomalías neuronales cuanto menos curiosas, como es el caso del síndrome de la mano ajena.
Este raro trastorno se caracteriza por la extraña sensación de «personificación» o independencia de uno de los miembros superiores. Una afectación tan sorprendente, que fue retratada en varias ocasiones en el cine o la televisión.
La descripción del síndrome de la mano ajena
Se le llama también síndrome de la mano extraña o de la mano alienígena. Fue descrito por primera vez en 1908 por el médico alemán Kurt Goldstein, quien atribuyó los síntomas a pacientes sometidos a ciertas cirugías para tratar trastornos psiquiátricos.
Se trata de un trastorno neurológico muy poco frecuente pero bastante notable, ya que conlleva una drástica modificación en la vida diaria de quien lo padece.
El síndrome se caracteriza por la actividad motora involuntaria de una de las manos del paciente. El mismo sujeto le atribuye vida propia a la mano, considerando que su comportamiento es independiente y autónomo, de forma distinta a las órdenes cognitivas conscientes que él mismo ejecuta. El paciente interpreta estos movimientos involuntarios como intencionales, por ello se acuñó también el concepto de «mano alienígena». En algunos casos, los pacientes personifican su miembro independiente, creyendo incluso que está «poseído» o que alguien puede controlarlo, desencadenando una serie de trastornos consecuentes que empeoran la situación.
La «mano ajena» puede realizar tareas complicadas como abrochar y desabrochar botones, agarrar objetos, lanzarlos, abrir y cerrar puertas, etc. En casos extremos, puede hacer algún movimiento violento que cause daño al mismo sujeto, o hasta atacarlo y poner en peligro su propia vida. El paciente no suele percatarse de lo que su «mano ajena» realiza hasta que llama su atención, por lo que suele generarle problemas sociales y en la vida rutinaria.
Situaciones de estrés, fatiga o ansiedad pueden incrementar el síntoma, haciendo más difícil la convivencia con este síndrome.
Posibles causas y tratamientos
Aunque existe relación entre el síndrome de la mano ajena y daños específicos en algunas áreas del cerebro, como el lóbulo frontal o la corteza cerebral, se cree que este trastorno es resultado de la desconexión entre las partes encargadas de controlar el cuerpo.
Según esta teoría, algunas regiones del cerebro serían capaces de controlar movimientos corporales sin ser conscientes de lo que hacen otras regiones, o sin hacer consciente al mismo sujeto.
En cuanto a los tratamientos, no existe actualmente ninguna medicación probada. Los síntomas pueden reducirse mediante algunos ejercicios diseñados para mantener ocupada a la «mano ajena», como sostener algún objeto. Para paliar la alta frecuencia de incidencias y mejorar su calidad de vida, se recomienda a los pacientes mantener sus entornos libres de estímulos y centrarse en la realización única de alguna tarea específica.
El síndrome de la mano ajena en la cultura popular
Las características excepcionales del síndrome de la mano ajena han llevado a que algunas películas y series de televisión exploren el trastorno en sus historias.
Como sería de esperar, la exitosa serie médica Dr. House presentó un caso del síndrome en el episodio 24 de la quinta temporada. Este programa es famoso por tratar afectaciones inusuales y extremadamente raras. Por lo que el hecho de incorporar un caso del síndrome se apega perfectamente con la premisa de la serie.
Otra producción conocida que trató este tema fue la película Al diablo con el diablo. En ella, Brendan Fraser pierde el control de su mano en una escena, aparentemente controlada por el diablo. Otro caso es el «enfrentamiento» con su mano derecha del personaje de Liar Liar, Fletcher Reede, interpretado por Jim Carrey.
En definitiva, el síndrome de la mano ajena no deja de ser uno de los muchos ejemplos insólitos que ofrece la medicina. Un campo que cada día abarca más descubrimientos y cuya investigación no hace más que enriquecer y favorecer la calidad de vida y la salud general de la población.
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28 diciembre, 2021 a las 01:34
Por el presente escrito quisiera contar mi historia, para que no caiga en el olvido y pueda servir a los estudiosos y a la ciencia, para que les surjan más dudas en relación a todas las especialidades, neurología, psiquiatría, psicología, etc. Que estudian el cerebro y la mente humana.
Mi historia comenzó hacia Primeros de Enero del año 2015. Todo comenzó tras una larga temporada de desempleo y que me lancé a una nueva aventura en una especialidad ajena a la que había estudiado, a través de un conocido que me dio la oportunidad. Todo ello empezaba con un curso de charla-formación de una semana de duración de lunes a viernes. Pues bien, como suele ser habitual en este tipo de formaciones el último día, y al final del todo suelen preguntar ¿qué te ha parecido el curso?, ¿qué le añadirías?, ¿qué dudas tienes?, etc. En este momento van preguntando de uno en uno y yo ya pensé que me tocaría el último y ya desde mediados de semana se me ocurrió la respuesta, pero mientras me tocaba el turno la iba construyendo. Cuando por fin me tocó el último, dije mi mensaje con tal ansiedad, como una emoción que viene de la boca del estómago, que al final expresarme me quedé unos segundos sin respiración, de una manera que nunca me había sucedido antes, no era el típico sofoco que no te deja continuar de hablar, era algo distinto. Se me pasó y nos volvimos para casa, ya que era las 14:00 h del viernes y teníamos todo el fin de semana por delante. Durante el fin de semana estuve dándole vueltas a lo que me había pasado y que el lunes se lo contaría a mi amigo, pero no fue así ya que llegó el lunes estuve en el nuevo trabajo y ya tenía unas ideas un poco extrañas y el martes me busqué una excusa para llevar a mi padre al médico y no ir a trabajar. La mañana fue tan extraña que a mi padre le acercó al médico mi hermana y yo me quedé delirando en casa con el jefe de mi hermana, fue tan súbito los delirios e ideas extrañas y además tan variadas, que cuando a la tarde me acerqué al hospital de urgencia con mi hermana, los médicos me diagnosticaron crisis de ansiedad y al día siguiente me dieron cita para Psiquiatría, yo como pensaba que estaba bien fui tranquilamente a la cita con mi hermana y no hubo los problemas que tuve el día anterior en el cuál hasta me durmieron por lo alterado que estaba.
Hasta aquí todo relativamente habitual en medicina, aunque con su gravedad, pero algo más común de lo que una persona sin problemas y que no piensa en los trastornos mentales puede hacerse una idea de la gente que tiene algún tipo de trastorno. Y más aún seguía haciendo vida normal y apenas le contaba mis delirios a mi familia, aunque en lo funcional actuaba correctamente y como de costumbre.
Aquí empecé sólo por las noches, cuando me iba a la cama a mover ambas manos y brazos de manera involuntaria y yo lo achacaba a que mi tía que vive en el extranjero me había dicho que mirase todo lo relativo al lenguaje y movimiento corporal. Además, todas las noches eran prácticamente el mismo tipo de movimientos complejos y coordinados, a los cuales yo me montaba una película y les asignaba nombre o función, pensando que era para que mis movimientos, saliese un mejor yo, con un lenguaje corporal de líder. A Todo esto, se le fue sumando que al escuchar por la noche música que me había recomendado mi Tía, se me movían los brazos de manera suave, pero elevándose y como si estuviera apartando cosas y se cortaban cuando terminaba la música. Uno de los conciertos duraba 3 horas y tenía 3 pausas, moviendo yo sólo los brazos cuando había música y esto se repitió todas las noches casi desde el principio del brote psicótico, hasta que me día la 2ª crisis a los 4-5 meses en mayo. Pero no solo tuve estos movimientos similares al balismo, sino que además tenía blefaroespasmo y en lugar de parpadear una sola vez, lo hacía repetidas veces 4-5 de manera muy rápida y se paraba, así como movimiento constante de mandíbula, y de vez en cuando sobre todo por la noche, tenía movimientos complejos de la boca y labios.
Hasta que una noche en la cama mi mano derecha comenzó a escribir frases con sentido de manera involuntaria, pero que lo hacía todo el día y en cualquier momento y escribía cosas como “poco a poco”, “sé fuerte”, “jajajajajaja”, “Loco de alegría cuando termine esto”. Al día siguiente cuando me levanté, lo primero que hice fue buscar por internet lo de escribir con la mano y el primer resultado que me dio fue el síndrome de la mano extraña. Yo renegaba de tener ese síndrome y pensaba que era una habilidad especial para ser un mejor yo. Aunque una de las veces, cuando me estaba aseando por la mañana, mi mano derecha cogió la maquinilla de afeitar que estaba en la encimera del lavabo, hice el gesto de apuñalarme con ella y la volví a dejar en su sitio, todo ello de manera ajena a mi voluntad.
Otra de las rarezas que me surgían de vez en cuando, aproximadamente una vez a la semana, era que de manera involuntaria gesticulaba o decía en voz baja algunas palabras o frases, como “Papá estoy loco”, “estás jodido” ó “Sé fuerte”. Así como alguna vez mover o girar la cabeza y gesticular los labios durante unos pocos segundos, como si fuese otro que controlaba mis movimientos.
Todo esto hasta que en mayo, me dio una crisis o “posesión” en la cual además de seguir con mis delirios, pero ya los expresaba a mi familia, tuve los movimientos que seguía como pauta todas las noches y esta vez decía en voz alta lo que cada noche pensaba con el movimiento que hacía, hasta que hubo un momento que fue como si me controlase una fuerza exterior y tumbado en la cama y durante unos minutos, estuve hablando en voz alta de manera involuntaria diciendo constantemente como si fuera una cuenta atrás y cortando la cuenta atrás con una palabra inconexa volvía al inicio de la cuenta atrás , moviendo ambos brazos de manera involuntaria y a modo de pistola apuntado y disparando a los médicos, policía y mi hermana que estaban en la habitación viendo atónitos la escena. Hasta que después de inyectarme un calmante e igual de súbito que vino esa “posesión” se acabó y volví a ser dueño de mis movimientos.
Esta vez si me ingresaron en un Hospital con área de psiquiatría y esta vez me diagnosticaron trastorno psicótico sin especificar y me recetaron antipsicóticos, los cuales llevo tomando desde entonces, aunque poca cantidad 2 mg de Risperidona por la noche. Seguía teniendo ideas raras y cambiantes, mi mano seguía escribiendo involuntariamente y cada vez que la dejaba parada o no hacía nada con ella. Pero la primera noche en el psiquiátrico dejé de tener los movimientos pautados de todas las noches, lo que me hizo pensar que había llegado al final de una fase de evolución y desde entonces no he vuelto a tener movimientos involuntarios y complejos por la noche. Sí tuve algún movimiento complejo durante el día, pero de manera esporádica y también dejé de hablar y/o gesticular frases involuntariamente. Internado estuve diez días y la psiquiatra que llevaba mi caso, sí que me preguntó por mi movimiento de escribir de la mano, pero yo me salí con otra respuesta para no confirmar que se movía de manera involuntaria.
Una vez salí del hospital, seguí con el día a día, escribiendo con la mano y con el blefaroespasmo, hasta que poco a poco caí en la cuenta de que eso no era normal ni justificable por cualquier causa y de buenas a primeras el blefaroespasmo cesó y cuando iba a contarle lo de la mano al psiquiatra que llevaba mi caso, dejé de escribir repentinamente y así estuve dos semanas hasta que me escribió sus últimas palabras “Fin …… Fin de la programación”.
Pese a que ya se terminaron todos mis movimientos raros e involuntarios, yo se lo expliqué al psiquiatra y creo que este no me hizo bastante caso, ya que después de una docena de visitas de apenas cinco minutos cada una, su diagnóstico es de Personalidad sensitiva, o paranoico, para los que no conocemos las denominaciones de los trastornos.
Y así unos años después no he vuelto a tener ni ideas delirantes, ni escribir con la mano, ni hablar involuntariamente, ni prácticamente ninguno de los movimientos que tenía, a excepción del bruxismo, el cual los médicos achacan a la Risperidona,2 mg por la noche y 10 mg de Brintellix a mediodía, pero visto todos esos trastornos del movimiento que he tenido lo pongo en duda.
Un saludo