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Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis

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Isolated hand weakness due to brain lesion.

B Yang¹, S Zhao², J Liu³

¹Department of Orthopedics, Guangdong Provincial Hospital of Chinese Medicine, Dade Road 111, Yuexiu District, Guangzhou 510120, Guangdong, China.

Hand Surgery & Rehabilitation

|August 15, 2022

Summary

This summary is machine-generated.

Hand weakness can be misdiagnosed as carpal tunnel syndrome when caused by a stroke. Prompt diagnosis and intervention, including angioplasty, significantly improved patient outcomes.

Keywords:

Accident vasculaire cérébral Brain lesion Carpal tunnel syndrome Diagnostic erroné Faiblesse isolée de la main Isolated hand weakness Lésion cérébrale Misdiagnosis Stroke Syndrome du canal carpien

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Area of Science:

Neurology
Vascular Medicine

Background:

Hand weakness is a common symptom that can be associated with various neurological and orthopedic conditions.
Misdiagnosis can occur when the underlying cause of hand weakness is not accurately identified, leading to delayed or inappropriate treatment.

Observation:

A patient presented with acute hand weakness, initially suspected to be carpal tunnel syndrome based on electromyography findings of a median nerve lesion at the wrist.
The absence of hand numbness and the immediate onset of weakness prompted further investigation, leading to a diagnosis of stroke via head CT scan.

Findings:

The patient was treated with medications and underwent percutaneous carotid and vertebral artery angioplasty with stent implantation.
Significant improvement in left hand weakness was observed post-intervention, suggesting a vascular origin.

Implications:

This case highlights the critical importance of considering stroke as a potential cause of isolated hand weakness, even when initial electrodiagnostic tests suggest peripheral nerve issues.
Physicians must maintain a high index of suspicion and correlate clinical presentation with imaging findings to avoid misdiagnosis and ensure timely management of cerebrovascular events.
Early recognition and treatment of stroke-related hand weakness can lead to better functional recovery and reduced long-term disability.