Almutairi Abdulkarim A, Alqahtani Mishari S, Alsayari Mohammed A, Alamri Aser F
Neuroscience Department, Neurology Division, Prince Sultan Military Medical City, Riyadh, SAU.
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Cureus. 2025 Jan 4;17(1):e76894. doi: 10.7759/cureus.76894. eCollection 2025 Jan.
Isolated foot drop is a neurological sign frequently linked to lower motor neuron (LMN) lesions, including peroneal nerve damage or L4-L5 radiculopathy. Nonetheless, upper motor neuron (UMN) lesions, such as strokes or tumors located in the parasagittal motor cortex, may sometimes manifest as isolated foot drops. The main causes of isolated foot drop secondary to central etiologies are uncommon, with few instances documented in the literature. An 83-year-old male presented with a four-day history of left isolated foot drop that started in the big toe and then spread to involve the whole foot. Clinical examination was negative for any other neurological deficit. Magnetic resonance imaging (MRI) of the cervical, thoracic, and lumbar spine showed only mild lumbar spinal stenosis at the L4/L5 level. Brain MRI revealed acute infarction foci in the right superior frontal gyrus. While uncommon, central causes of isolated foot drop should be taken into account when peripheral examinations yield inconclusive results. This case highlights the significance of a thorough diagnostic method, encompassing brain imaging, to detect lesions in the central nervous system. Timely identification and management of these cases are essential for enhancing patient outcomes and avoiding misdiagnosis.
孤立性足下垂是一种常与下运动神经元（LMN）病变相关的神经学体征，包括腓总神经损伤或L4-L5神经根病。然而，上运动神经元（UMN）病变，如矢状旁运动皮层的中风或肿瘤，有时也可能表现为孤立性足下垂。中枢性病因导致的孤立性足下垂的主要原因并不常见，文献中记载的病例很少。一名83岁男性，有四天的左侧孤立性足下垂病史，始于大脚趾，随后蔓延至整个足部。临床检查未发现任何其他神经功能缺损。颈椎、胸椎和腰椎的磁共振成像（MRI）仅显示L4/L5水平有轻度腰椎管狭窄。脑部MRI显示右侧额上回有急性梗死灶。虽然不常见，但当外周检查结果不明确时，应考虑孤立性足下垂的中枢性病因。该病例强调了全面诊断方法的重要性，包括脑部成像，以检测中枢神经系统病变。及时识别和处理这些病例对于改善患者预后和避免误诊至关重要。
