While peripheral lesions account for a significant proportion of cases presenting with isolated motor hand weakness (Box 1), this case illustrates the importance of recognizing infarction of the hand knob area as a cause for such a presentation. An accurate history is essential, along with a detailed systemic and neurological examination performed, particularly looking for other neurological findings that may hint towards a peripheral cause or involvement of more areas cortically. The presence of weakness of all muscle groups is unusual in peripheral nerve lesions and led in this case to the initial investigation with cerebral MRI, which provided the diagnosis.
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References
- Yousry TA et al. Localization of the motor hand area to a knob on the precentral gyrus; A new landmark. Brain 1997;120: 141–157.
- Chen P, Hsu H, Wang P. Isolated Hand Weakness in Cortical Infarctions. J Formos Med Assoc 2006; 105(10): 861–865.
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