Cerebral Infarction Presenting with Unilateral Isolated Foot Drop

Abstract

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.

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

“…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) .…”

Bilateral Central Foot Drop in a Pediatric Patient

“…CFD developed in 1 patient after surgical debridement of the parasagittal abscess [4]. 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].…”

“…Blockage of the innervation of these muscles results in foot drop [3]. Beside 5th lumbar nerve compression and peroneal nerve entrapment, other reasons for foot drop are trauma to the leg, diabetes mellitus, vasculitis, connective tissue disorders, leg compartment syndromes, muscular distrophy and leprosy [1,2,4,5]. …”

“…Foot drop is an inability to dorsiflex the ankle and toe, with difficulty in eversion of the foot [1,2,3]. Dorsiflexion of the foot is accomplished with the tibialis anterior, extensor digitorum longus and extensor hallucis longus muscles, which are innervated by the 4th and 5th lumbar nerves and the 1st sacral nerve [1].…”

“…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.…”