ABSTRACT
An 82-year-old woman developed a droopy right eyelid with ipsilateral hemiparesis. Her ocular symptom was caused by weakness of the right frontalis, which is usually seen in patients with peripheral facial nerve palsy. However, head MRI showed acute cerebral infarction of the left lenticulostriate artery, and electroneurography did not detect damage to the right facial nerve. To explain the pathophysiology in this patient, asymmetrical bilateral cortex innervation to the right upper face was hypothesized. This case suggested that patients with some hemispheric strokes could develop upper facial weakness mimicking facial nerve palsy, and clinicians should pay attention to this potential pitfall in the differential diagnosis of facial nerve palsy.
Subject(s)
Facial Paralysis , Magnetic Resonance Imaging , Humans , Female , Aged, 80 and over , Facial Paralysis/etiology , Facial Paralysis/diagnosis , Diagnosis, Differential , Cerebral Infarction/diagnostic imaging , Cerebral Infarction/complications , Cerebral Infarction/etiology , Basal Ganglia Cerebrovascular Disease/diagnostic imaging , Basal Ganglia Cerebrovascular Disease/complications , Basal Ganglia Cerebrovascular Disease/etiologyABSTRACT
A 75-year-old man developed sudden-onset tetraparesis preceded by chest pain. MRI of the cervical spine on the day of onset showed no abnormalities. Although his motor symptoms improved gradually, the weakness of the muscles innervated by the C5 nerve root persisted. Sensory and autonomic deficits were detected on an additional neurological examination, and follow-up MRI eight days after onset revealed spinal cord infarction at the right anterior horn at C3-C4. This case suggests that motor symptoms mimicking a radiculopathy could be present during the course of spinal cord infarction.