S Bielsa-Martín1, J Sanahuja-Montesinos. 1. Servicio de Medicina Interna, Hospital Universitario Arnau de Vilanova, Lleida, Spain. silviabmartn@yahoo.es
Abstract
INTRODUCTION: Paralysis of the fingers secondary to injury to the central nervous system or peripheral pseudoparalysis is an infrequent pathological condition. The most common form is the one affecting the ulnar area, although it has also been reported as affecting the radial area or even the index finger. CASE REPORT: We report a case of right-side pseudoparalysis of the ulnar with the fourth and fifth fingers in a bending posture in a 61-year-old male with risk factors for atherothrombosis. The definitive diagnosis was obtained by magnetic resonance (MR) imaging of the head, which revealed frontal cortical infarction on the left side. CONCLUSIONS: The paper includes a discussion on the affected anatomical regions that can trigger this condition, the most important of which is a specific segment of the precentral gyrus with a characteristic shape, that is, either an inverted omega or, less often, an epsilon shape lying horizontal in the axial plane. The literature, however, also includes reports of functional MR imaging or intracortical microstimulation being used to show models of spatial overlay in the cortical motor area of the hand. From a more clinical point of view, it becomes clear that the central nervous system must be evaluated for a stroke or even some other pathology as the causation of an isolated paresis of the fingers, especially if no sensory disorder exists.
INTRODUCTION: Paralysis of the fingers secondary to injury to the central nervous system or peripheral pseudoparalysis is an infrequent pathological condition. The most common form is the one affecting the ulnar area, although it has also been reported as affecting the radial area or even the index finger. CASE REPORT: We report a case of right-side pseudoparalysis of the ulnar with the fourth and fifth fingers in a bending posture in a 61-year-old male with risk factors for atherothrombosis. The definitive diagnosis was obtained by magnetic resonance (MR) imaging of the head, which revealed frontal cortical infarction on the left side. CONCLUSIONS: The paper includes a discussion on the affected anatomical regions that can trigger this condition, the most important of which is a specific segment of the precentral gyrus with a characteristic shape, that is, either an inverted omega or, less often, an epsilon shape lying horizontal in the axial plane. The literature, however, also includes reports of functional MR imaging or intracortical microstimulation being used to show models of spatial overlay in the cortical motor area of the hand. From a more clinical point of view, it becomes clear that the central nervous system must be evaluated for a stroke or even some other pathology as the causation of an isolated paresis of the fingers, especially if no sensory disorder exists.