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Pure motor monoparesis due to ischemic stroke

Akiyuki Hiraga1

  • 1Department of Neurology, Chiba Rosai Hospital, 2-16 Tatsumidai-Higashi, Ichihara-shi, Chiba, Japan. hiragaa@yahoo.co.jp

The Neurologist
|November 3, 2011
PubMed
Abstract

Insights

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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