The useless hand of Oppenheim

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Abstract

Hermann Oppenheim described the ‘Useless Hand’ in 1911 as a classical but uncommon presentation of multiple sclerosis, in which a hand loses useful function due to proprioceptive loss, with relatively preserved motor function. Light touch perception may be subjectively altered or can be relatively intact. The lesion is (usually) a demyelinating plaque in the posterior columns of the cervical spinal cord. Depending on its location, it may affect one limb, or if more central, may produce a bilateral (if asymmetrical) picture. This article reviews a clinical case, historical background, pathophysiology as well as examination tips to aid its recognition.

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