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Pure motor stroke with major involvement of the index finger
  1. M Kobayashi,
  2. M Sonoo,
  3. T Shimizu
  1. Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan
  1. Correspondence to:
 M Sonoo
 Department of Neurology, Teikyo University School of Medicine, Kaga 2–11–1, Itabashi-ku, Tokyo 173, Japan; sonoommed.teikyo-u.ac.jp

https://doi.org/10.1136/jnnp.2003.015685

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    A selective weakness of a particular group of fingers due to cortical infarction has been reported by several authors.1–3 This finding is related to the controversy over the somatotopic organization of the primary motor cortex (M1). Traditionally, a discrete somatotopic arrangement for individual fingers, with the radial fingers represented laterally and the ulnar fingers medially, has been assumed. However, recent theories have suggested functional overlapping of the cortical representation of the fingers. We describe here a case presenting with major weakness of the index finger due to a cortical infarction confirmed by MRI.

    Case report

    A 71 year old right handed man noted difficulty in using his toothbrush one morning. He complained of weakness in his right index finger and was admitted to our hospital on the day of onset. He had no previous illnesses nor risk for stroke. Neurological examination revealed the following muscle weaknesses: extension, abduction, and adduction of the right index finger (2-/5 as scored by the Medical Research Council (MRC) grading …

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