[A case of pure motor isolated finger palsy due to cerebral infarction]
Eiji Kitamura1, Junichi Hamada, Kosuke Suzuki
1Department of Neurology, Kitasato University School of Medicine.
Insights
A rare case of pure motor isolated finger palsy (PMIFP) resulted from a small stroke in the brain. This condition, often mistaken for peripheral neuropathy, highlights the importance of central nervous system evaluation.
Area of Science:
- Neurology
- Cardiology
Background:
- Atrial fibrillation and hypertension are common comorbidities.
- Cardiogenic embolism is a significant cause of ischemic stroke.
Observation:
- A 73-year-old man presented with sudden, isolated weakness in his left thumb and index finger.
- Neurological examination revealed no sensory deficits, only motor impairment in specific finger muscles.
- Brain MRI identified an acute cerebral infarction in the right precentral knob.
Findings:
- The cerebral infarction was diagnosed as a cardiogenic embolism.
- The patient's symptoms were consistent with pure motor isolated finger palsy (PMIFP).
- This presentation is rare, particularly with a small cerebrocortical lesion.
Implications:
- PMIFP associated with small cortical lesions is an uncommon neurological presentation.
- It suggests that some cases diagnosed as peripheral neuropathy may actually be central PMIFP.
- This case underscores the need to consider central nervous system causes for isolated motor deficits.
Abstract:
A 73-year-old man, a right-handed, has been pointed out his atrial fibrillation and seen a doctor regularly for varicose veins of left leg and hypertension. He had complaint of a sudden paralysis of his left thumb and index finger while drinking beer. The next day, there was no improvement and he was admitted to our hospital. Neurological examination revealed mild weakness of the most muscles of both thumb and index finger which were innervated by radial nerve, ulner nerve, and median nerve. But he had no any other neurological deficits including sensory system. A brain MRI revealed the acute-stage cerebral infarction in the right precentral knob. With other examinations, we diagnosed the cerebral infarction as cardiogenic embolism. Pure motor isolated finger palsy (PMIFP) in association with cerebrocortical small lesion is rare. It is probable that some cases with diagnosed of peripheral neuropathy was actually PMIFP from central nervous system disturbance.
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