Abstract
Pseudo-peripheral palsy is an infrequent presentation of ischemic stroke, which often leads to a misdiagnosis of peripheral nerve pathology. It is characterized by palsy of the hand or a group of fingers and altered sensitivity which can simulate peripheral nerve damage. We report a case of a patient who had pseudo-peripheral palsy with predominantly ulnar motor involvement, associated with multimodal hypoesthesia in the hypothenar region; illustrating the difficulty of topographic localization to explain motor and sensory involvement by a mononeuropathic, radicular or spinal syndrome. We highlight the importance of an adequate semiological evaluation to accurately diagnose and manage these pathologies.
References
Hassan KM. Fractional arm weakness as presentation of stroke due to posterior borderzone infarct: A report of two cases. An Indian Acad Neurol. 2010;13(4):302-4.
Castaldo J, Rodgers J, Rae-Grant A, Barbour P, Jenny D. Diagnosis and neuroimaging of acute stroke producing distal arm monoparesis. J Stroke Cerebrovasc Dis. 2003;12(6):253-8.
Peters N, Müller-Schunk S, Freilinger T, Düring M, Pfefferkorn T, Dichgans M. Ischemic stroke of the cortical "hand knob" area: stroke mechanisms and prognosis. J Neurol. 2009;256(7):1146-51.
Tahir H, Daruwalla V, Meisel J, Kodsi SE. Pseudoradial nerve palsy caused by acute ischemic stroke. J Investig Med High Impact Case Reports 2016;4(3):1-4.
Jusufovic M, Lygren A, Aamodt AH, Nedregaard B, Kerty E. Pseudoperipheral palsy: A case of subcortical infarctionimitating peripheral neuropathy. BMC Neurol. 2015;15(1):1-4.
Tei H. Monoparesis of the right hand following a localised infarct in the left "precentral knob". Neuroradiology. 1999;41(4):269-70.
Terao, Yasuo, Hideaki Hayashi, Takemasa Kanda HT. Discrete Cortil Infarction With Prominent Impairment of Thumb Flexion. Stroke. 1993;24(1):2118-21.
Lampl Y, Gilad R, Eshel Y, Sarova-Pinhas I. Strokes mimicking peripheral nerve lesions. Clin Neurol Neurosurg. 1995;97(3):203-7.
Kawabata Y, Miyaji Y, Joki H, Seki S, Mori K, Kamide T, et al. Isolated index finger palsy due to cortical infarction. J Stroke Cerebrovasc Dis. 2014;23(10):e4756.
Yousry TA, Schmid UD, Alkadhi H, Schmidt D, Peraud A, Buettner A, et al. Localization of the motor hand area to a knob on the precentral gyrus. A new landmark. Brain. 1997;120(1):141-57.
Caulo M. New morphologic variants of the hand motor cortex as seen with MRI maging in a large study population. Am J of Neuroradiology. 2007; 28:1480-5.
Hiraga A. Pure motor monoparesis due to ischemic stroke. The Neurologist. 2011;17:301-8.

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