Isolated Lower Limb Weakness Following Hemorrhagic Stroke: A Case Report

Area of Science:

• Neurology
• Internal Medicine

Background:

• Isolated limb weakness, or monoparesis, can stem from various causes, both central and peripheral.
• Prompt diagnosis is crucial for effective management and improved patient outcomes.

Observation:

• A patient presented with isolated left lower limb weakness.
• Medical history included a significant smoking history, type II diabetes, and asymptomatic atrial fibrillation.
• Neurological examination revealed intact cranial nerves, upper limb function, sensation, and reflexes, with weakness localized to the left leg.

Findings:

• Brain imaging identified a right frontal intraparenchymal hemorrhage.
• The hemorrhage remained stable during hospitalization.
• The patient's limb weakness significantly improved by the time of discharge.

Implications:

• This case underscores that monoparesis can be the sole presenting symptom of a stroke.
• It highlights the importance of considering central nervous system causes, particularly stroke, even with seemingly localized peripheral symptoms.
• Accurate diagnosis of stroke presenting as isolated limb weakness is critical to prevent misdiagnosis and ensure timely intervention.