Document Detail


Isolated hand palsy due to cortical infarction: localization of the motor hand area.
MedLine Citation:
PMID:  18090716     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the cortical presentation of the hand area according to MRI images of the infarcted area in patients who have predominantly hand weakness. BACKGROUND: "Pseudoperipheral palsy" is an old term employed to describe a rare clinical picture consisting of predominant weakness of the hand in association with cerebral infarction. Because the organization of the cortical efferent area of the hand has not been fully defined, this phenomenon merits attention. Recent advances in functional imaging have stimulated renewed interest in the cortical mapping of various body parts, particularly that of the hand. METHODS: The patients who had isolated hand palsy due to cerebral infarction underwent clinical examination and cerebral MRI investigation to locate the exact lesion site. RESULTS: Eight patients (6 men, 2 women) aged 55 to 80 years (mean 69 years) were included in this study. All had at least one risk factor for cerebrovascular disease. All our 8 patients presented with hand palsy and lesions were detected in the contralateral precentral gyrus in all cases. The lesions were located in the middle to lower portion of the anterior wall of the central sulcus just posterior to the intersection of the superior frontal and precentral sulci. CONCLUSION: Our findings indicate that the hand area in the cerebral motor cortex is located in the middle to lower portion of the anterior wall of the central sulcus, that is, in Brodmann area 4. We present our 8 patients showing isolated hand palsy due to a discrete cortical infarction on MRI to expand the knowledge about cortical localization of the hand area.
Authors:
Mehmet Celebisoy; Tolga Ozdemirkiran; Figen Tokucoglu; Derya N Kaplangi; Sehnaz Arici
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The neurologist     Volume:  13     ISSN:  1074-7931     ISO Abbreviation:  Neurologist     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-12-19     Completed Date:  2008-03-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503763     Medline TA:  Neurologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  376-9     Citation Subset:  IM    
Affiliation:
Department of Neurology, Atatürk Training and Research Hospital, Izmir, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Brain Ischemia / complications,  physiopathology
Causality
Cerebral Infarction / complications,  pathology*,  physiopathology
Dominance, Cerebral / physiology
Female
Hand / innervation,  physiopathology*
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Motor Cortex / anatomy & histology,  pathology*,  physiopathology
Movement / physiology
Muscle, Skeletal / innervation,  physiopathology
Paralysis / etiology,  pathology*,  physiopathology
Paresis / etiology,  pathology,  physiopathology
Predictive Value of Tests
Prospective Studies
Pyramidal Tracts / physiopathology

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