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Pseudoulnar palsy with concurrent wrist drop: case report.

Benjamin Hershfeld¹, Sydney Wolin¹, Alexandra C Echevarria²

¹New York Institute of Technology College of Osteopathic Medicine, Glen Head.

Annals of Medicine and Surgery (2012)

|April 5, 2024

Summary

A rare case of pseudoulnar palsy with wrist drop resulted from a stroke in the brain's "hand knob" area. This highlights the importance of considering central causes for peripheral nerve symptoms.

Keywords:

hand knob gyrus precentral gyrus infarction primary motor cortex pseudoulnar palsy wrist drop

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Area of Science:

Neurology
Neuroscience
Cerebrovascular Disease

Background:

Pseudoulnar palsy typically results from infarction in the medial precentral gyrus's
hand knob,
affecting the primary motor cortex.

Observation:

A 78-year-old female with hypertension and hyperlipidemia presented with sudden right wrist drop and weakness in her fourth and fifth digits.
Neuroimaging confirmed an acute infarction in the medial precentral gyrus, specifically the hand knob area.

Findings:

This case uniquely presented with both ulnar (fourth and fifth digit weakness) and radial (wrist drop) deficits.
The infarction pattern in the medial hand knob gyrus was responsible for the combined neurological deficits.

Implications:

This case emphasizes considering central neurological causes for peripheral-like symptoms, particularly in elderly patients with vascular risk factors.
Early diagnosis and intervention are crucial for managing stroke-related neurological deficits and preventing long-term complications.