An unexpected reason for isolated foot drop: Acute stroke

The differential diagnosis of acute weakness (aw) in emergency departments (ed) is broad and includes both neurological and medical reasons. we describe an 81-year-old female patient with cortical infarct presenting with sudden onset isolated foot drop,which to the best of our knowledge,was the third case in english literature. an 81-year-old female was admitted to our ed with a 12-hour history of left-sided foot drop. her motor strength was normal throughout the upper and lower extremities,except for weakness in the left ankle and toe dorsiflexors. other examination findings were unremarkable. diffusion-weighted magnetic resonance imaging (dwi-mr) revealed a focal high intensity signal in the right precentral gyrus at high convexity with a cerebral infarct. detailed physical examinations and histories are extremely important for exact diagnosis and differentials of patients with aw. this case reminds us that a small infarct area of central nervous system may mimic peripheral nerve lesions,especially in elderly patients. although the presentation of such complaints may play a distracting role to emergency physicians,strokes must always be taught regarding elderly patients and,if necessary,infarct areas should be confirmed with dwi-mr. © 2017,professional medical publications. all rights reserved.