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J Neurol Neurosurg Psychiatry 2009;80:1142 doi:10.1136/jnnp.2009.172445
  • Neurological picture

Isolated toe paralysis caused by a small cortical infarction

  1. L Cattaneo1,
  2. L Cucurachi2,
  3. G Pavesi3
  1. 1
    Centro Interdipartimentale Mente-Cervello (CIMeC), Università di Trento, Italy
  2. 2
    Ospedale “S Chiara”, Trento, Italy
  3. 3
    Dipartimento di Neuroscienze, Università di Parma, Italy
  1. Correspondence to Dr L Cattaneo, Centro Interdipartimentale Mente-Cervello (CIMeC), Università di Trento, Via delle Regole, 101, I-38100 Mattarello (TN), Italy; luigi.cattaneo{at}unitn.it
  • Accepted 1 February 2009

Case report

A 66-year-old man developed acutely distal weakness of the left leg. Neurological examination 8 h after the onset revealed isolated weakness of the left foot and toes. Ankle dorsiflexion and eversion were more affected than inversion and plantar flexion. After 48 h from the onset of symptoms, the patient had completely recovered from ankle weakness whereas paralysis of toe dorsiflexion and severe paresis of toe plantar flexion persisted. Tapping movements with the left foot were slower than on the right and recruited synkinetic movements of the ipsilateral knee and hip joints. Tapping with the left foot induced involuntary contralateral “mirror” movements but no such movements occurred …

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