Pure motor monoparesis due to ischemic stroke
1Department of Neurology, Chiba Rosai Hospital, 2-16 Tatsumidai-Higashi, Ichihara-shi, Chiba, Japan. hiragaa@yahoo.co.jp
The Neurologist
|November 3, 2011
Summary
Pure motor monoparesis (PMM) following ischemic stroke (IS) is rare and often misdiagnosed. Early diagnosis using diffusion-weighted imaging is crucial for effective treatment and good prognosis.
Area of Science:
- Neurology
- Stroke Medicine
- Neuroimaging
Background:
- Pure motor monoparesis (PMM) is an uncommon ischemic stroke (IS) presentation.
- Characterized by isolated motor deficit in one limb without cranial or sensory deficits.
- Often misdiagnosed, delaying appropriate stroke management.
Purpose of the Study:
- To highlight the diagnostic challenges of PMM secondary to IS.
- To identify common lesion locations and clinical features of PMM.
- To emphasize the importance of early recognition and diagnosis.
Main Methods:
- Review of literature on pure motor monoparesis following ischemic stroke.
- Analysis of lesion sites, clinical presentations, and diagnostic tools.
- Focus on diffusion-weighted imaging (DWI) utility.
Main Results:
- Cortical lesions (precentral knob, anterior cerebral artery territory) are most common.
- Subcortical, corona radiata, internal capsule, and brainstem lesions are less frequent.
- Distal-dominant weakness without pyramidal signs is characteristic; prognosis is generally favorable.
Conclusions:
- Acute monoparesis warrants careful evaluation, especially in elderly patients with stroke risk factors.
- Ischemic stroke should be considered in the differential diagnosis of acute monoparesis.
- Diffusion-weighted imaging is the key diagnostic modality for PMM due to IS.
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