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- W2065373172 abstract "Objective: To document a rare presentation of stroke. Background Lhermitte described 9pseudoperipheral palsy9 as a weakness of fingers due to a CNS lesion, now thought to be 1% of all ischaemic strokes. Often misdiagnosed, the opportunities to identify and treat stroke risk factors are missed. Design/Methods: A 62 year-old male presented with difficulty of finger movements and wrist drop of left hand, for two days. Patient had history of hyperlipedemia. On exam, his blood pressure was 195/100mm Hg with normal vitals,left wrist drop, weak finger flexion,abduction and adduction, weak thumb extension flexion and adduction, with brisk left brachioradialis reflex. Rest of the neurological examination was normal. Results: Due to isolated hand weakness, we were tempted to think of peripheral lesion, however due to involvement of muscle supplied by radial, medial and ulner nerve and brisk brachioradialis reflex, MRI brain was done to look for central cause, which showed diffusion positive lesion in mid of the right precentral gyrus suggestive of acute stroke. Patient was managed for acute stroke and was discharged home with mild improvement of weakness. Conclusions: Functional MRI suggests that the w or E shaped area (the precentral knob) on the precentral gyrus in the axial plane is the hand area. Medial portion of the precentral knob representing topographically ulnar-sided fingers may correspond to the borderzone area between the middle cerebral artery (MCA) and the anterior cerebral artery, whereas the lateral portion representing radial-sided fingers is supplied by distal MCA branches. Cortical hand paralysis characteristically cause partial finger paralysis, producing pseudo-ulner or pseudoradicular pattern with difference in the severity of paralysis between the radial side and the ulnar side, important in differentiating cortical hand paralysis from subcortical lesions. Discrete functional cortical areas for each digit exist and are sequentially arranged, with considerable overlap of control of adjacent territory. Disclosure: Dr. Vyas has nothing to disclose. Dr. Staudinger has nothing to disclose. Dr. Hanson has nothing to disclose." @default.
- W2065373172 created "2016-06-24" @default.
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- W2065373172 date "2012-04-22" @default.
- W2065373172 modified "2023-09-28" @default.
- W2065373172 title "Isolated Hand Paralysis Due to Stroke in Precentral Knob Region (P02.191)" @default.
- W2065373172 doi "https://doi.org/10.1212/wnl.78.1_meetingabstracts.p02.191" @default.
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