Isolated foot drop in acute infarction of the supplementary motor area

Park, Kang Min; Kim, Sung Eun; Shin, Kyoungsoon; Park, Jinse; Kim, Si Eun; Kim, Hyung Chan; Mun, Chi-Woong; Ha, Sam Yeol

doi:10.1016/j.clineuro.2013.07.008

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…Isolated foot drop of a single leg is the weakness of the dorsiflexor muscles of the foot, and this usually arises painlessly due to peripheral neuropathy, such as peroneal nerve damage or radiculopathy 1 7) . Isolated painless foot drop is also caused by central origin, but this is rare, and there are only several reports of acute infarction mimicking peroneal neuropathy 4 5 9 10) . Painless foot drop due to lumbar disorder is also uncommon 1 3) .…”

Section: Discussionmentioning

confidence: 99%

Isolated Painless Foot Drop due to Cerebral Infarction Mimicking Lumbar Radiculopathy: A Case Report

Kim

Yoon

2015

Korean J Spine

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Although they usually originate from peripheral problems, foot drop is caused by lesions affecting the neural pathway related to dorsiflexor muscles, whether of central or peripheral origin. We present a patient with sudden isolated foot drop caused by a small infarct in the primary motor cortex mimicking a peripheral origin. This report indicates that patients presenting isolated foot drop should be managed carefully and the possibility of both central and peripheral causes should be considered. To our knowledge, this is the first report of sudden isolated foot drop caused by a cortical infarction mimicking lumbar radiculopathy.

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Section: Discussionmentioning

confidence: 99%

Isolated Painless Foot Drop due to Cerebral Infarction Mimicking Lumbar Radiculopathy: A Case Report

Kim

Yoon

2015

Korean J Spine

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“…Therefore, the lesions involving the SMA may cause astasia or apraxia rather than weakness. But, rarely it can cause motor deficits because the SMA proper transfers corticospinal efferences and is connected with the primary motor cortex7). There are only two previous reports on isolated foot drop caused by lesions other than parasagittal lesions1,3).…”

Section: Discussionmentioning

confidence: 99%

Cerebral Infarction Presenting with Unilateral Isolated Foot Drop

Kim

Park

Koh

et al. 2014

J Korean Neurosurg Soc

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Weakness of the dorsiflexor muscles of the ankle or toe, referred to as foot drop, is a relatively common presentation. In most cases, foot drop is caused by a lower motor neuron disease such as peroneal peripheral neuropathy, L4-5 radiculopathic sciatic neuropathy, or polyneuropathy. Although upper motor neuron lesions can present as foot drop, the incidence is very rare. Here, we report an extremely rare case in which foot drop was the only presenting symptom of cerebral infarction.

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“…Pathologies causing CFD are mainly in the parasagittal area close to the motor cortex, which corresponds to the medial homunculus of the PMC that is responsible for ankle and toe movements [2]. Foot drop secondary to a lesion of the SMA has been described only once in an adult patient by Park et al [7]. In our case, the motor fibers descending from the PMC were observed to be depressed posteriorly and those descending from the SMA were missing bilaterally on DTI.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…They work together in initiating motor activity [1,6,7]. Pathologies in the PMC, SMA, internal capsule, corona radiata, cerebral peduncle, medulla and spinal pyramidal tract can be the origin of central foot drop (CFD) [2,7]. Our aim was to analyze all foot drop cases secondary to central brain pathologies in a pediatric population, with an intention to define the underlying etiologies as well as diagnostics and management strategies and to present an example, i.e.…”

Section: Introductionmentioning

confidence: 99%

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Bilateral Central Foot Drop in a Pediatric Patient

Işık

Akakın²,

Ekşi

et al. 2016

Pediatr Neurosurg

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Foot drop is an inability to dorsiflex the ankle and toe. Primary causes of foot drop are compression or lesion of the 5th lumbar nerve and entrapment of the peroneal nerve at the head of the fibula. Rarely, some central nervous system lesions lead to foot drop. A 16-year-old boy was admitted with blunt head trauma that had happened in an assault. The muscle strength of the bilateral tibialis anterior, bilateral extensor digitorum longus and bilateral extensor digitorum brevis were Medical Research Council grade 1. Deep tendon reflexes of both ankles were hyperactive, with bilateral clonus and bilateral Babinski sign. There were cerebral contusions with peripheral edema in both motor strip areas extending anteriorly into the frontal lobes, with right-sided epidural-subdural hematoma. On brain MRI, the superior sagittal sinus was open. The epidural-subdural hematoma did not progress in its dimensions. The patient was treated conservatively. He recovered fully with regression of the contusions and epidural-subdural hematoma 4 months after the trauma. Foot drop due to upper motor neuron pathologies is more spastic in nature, different from what happens following lumbar disc herniation or peroneal nerve dysfunction. Treatment of central foot drop should be planned according to the underlying pathology.

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Isolated foot drop in acute infarction of the supplementary motor area

Cited by 4 publications

References 7 publications

Isolated Painless Foot Drop due to Cerebral Infarction Mimicking Lumbar Radiculopathy: A Case Report

Isolated Painless Foot Drop due to Cerebral Infarction Mimicking Lumbar Radiculopathy: A Case Report

Cerebral Infarction Presenting with Unilateral Isolated Foot Drop

Bilateral Central Foot Drop in a Pediatric Patient

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