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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Contributors LW has had clinical interactions with the patient discussed in the case study, conceived and wrote the article, as well as produced required amendments. JG has had clinical interactions with the patient discussed in the case study, and has contributed substantially to the article by reviewing, critiquing and recommending additions, and editing.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by Alasdair Coles, Cambridge, UK.