An 18-year-old female presented with acute onset of abnormal sensation over her left upper limb particularly over the hand 7-10 days before. However, she has no relevant history or family history suggestive of her presenting symptom. It was a vague symptom which she found difficult to describe. However, she could mention it as a sense of her hand being useless. She did not give any history of numbness, painful sensation in the form of tingling or burning sensations. The only description she

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... each time was that her hand appears to be useless. For the above symptoms, she had consulted many doctors prior to our hospital and had received symptomatic treatment. She was also diagnosed to have hysterical conversion reaction or psychosomatic illness as there were no deficits. On detail neurological examination her higher mental functions were normal, cranial nerve examinations were unremarkable. Tone in all the four limbs was normal and power was 5/5 bilaterally. Reflexes were 2+ bilaterally at all the joints. Plantar reflex was flexor bilaterally. Sensory examination was normal for all the modalities and there were no cerebellar signs. Since, patient was concerned by her abnormal "sensory useless hand" description MRI brain was advised which showed T2 [Table/Fig-1] and FLAIR [Table/Fig-2] hyperintensities in left MCP and pons with peripheral restriction on DWI [Table/Fig-3] with contrast enhancement highly suggestive ABSTRACT Sensory useless hand of Oppenheim was first described in 1911. It is an unusual presentation of Multiple Sclerosis. It is characterised as a functional disorder with loss of sensory modalities and preserved motor functions. Here the present authors report a case of an 18-year-old girl with acute vague symptoms described as 'uselessness' of left hand. Clinical examination of the neurological system was unremarkable. Imaging investigations revealed hyper-intensities in the Middle Cerebral Peduncle (MCP) and pons, suggestive of demyelination. Treatment with Intravenous and oral steroids showed improvement of symptoms. On follow-up patient presented with cerebellar symptoms after previous complete resolution. Imaging studies showed no new lesion suggesting the old lesion responsible for recurrence of new symptoms. This distribution of symptoms of space and time suggests the diagnosis of useless hand of Oppenheim a rare and uncommon presentation of multiple sclerosis. [Table/Fig-1]: T2 weighted MRI showing hyper intensity in left MCP and pons. [Table/Fig-2]: FLAIR MRI showing hyper intensity in left MCP and pons with mild perilesional oedema. of demyelination. Size of the lesion was 2 cm. Rest of the brain MRI and screening of whole spine was normal. Clinical diagnosis of "Sensory useless hand of Oppenheim" secondary to demyelination was kept. Since lesion was single and size was 2 cm diagnosis of