Useless hand syndrome with astereognosis in multiple sclerosis.

We report on a patient with multiple sclerosis (MS) who developed bilateral useless hand syndrome (UHS) and astereognosis. Clinical features of UHS in our patient are similar to limb-kinetic apraxia with astereognosis. Cervical T1-weighted magnetic resonance imaging revealed a gadolinium-enhanced lesion at the level of C3-C4, mainly involving the posterior cord. This patient suggests that posterior cord lesions at high cervical levels cause UHS and astereognosis in MS, involving the sensorimotor integration needed to execute complex finger movements.