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Pure monoparesis: a particular stroke subgroup?

Malin Maeder-Ingvar1, Gus van Melle, Julien Bogousslavsky

  • 1Department of Neurology, University Hospital of Vaud, Lausanne, Switzerland. Malin.Maeder-Ingvar@chuv.hospvd.ch

Archives of Neurology
|August 10, 2005
PubMed
Summary

Acute stroke presenting as pure monoparesis is typically ischemic with a good outcome. This rare condition, affecting face, arm, or leg, shows diverse lesion locations and few risk factors, suggesting no specific investigation plan is needed.

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Area of Science:

  • Neurology
  • Stroke Medicine
  • Neuroimaging

Background:

  • Acute stroke presenting as pure monoparesis (affecting face, arm, or leg) is a rare clinical presentation.
  • Distinguishing monoparesis from more extensive motor deficits is crucial for understanding stroke entities.

Purpose of the Study:

  • To investigate whether acute stroke presenting as pure monoparesis is a distinct entity compared to strokes with broader motor deficits.
  • To analyze the characteristics, localization, and risk factors associated with pure monoparesis.

Main Methods:

  • Analysis of the Lausanne Stroke Registry (1979-2000) data.
  • Inclusion criteria: 195 patients with pure monoparesis (face, arm, or leg).
  • Review of clinical presentation, neuroimaging findings (CT/MRI), and stroke risk factors.

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Main Results:

  • Monoparesis predominantly involved ischemic stroke (>95%) with favorable outcomes.
  • Lesion locations varied: internal capsule for facial, superficial middle cerebral artery for arm, and anterior cerebral artery for leg deficits.
  • Fewer risk factors were observed in monoparesis patients compared to those with hemiparesis or other stroke types, with hypertension being the most common but not significantly different.

Conclusions:

  • Pure monoparesis exhibits a wide range of stroke localizations and etiologies.
  • No specific subgroup characteristics were identified within monoparesis.
  • A tailored investigation plan is not recommended for patients presenting with pure monoparesis due to its diverse nature.