Isolated Leg Monoparesis in a Patient with Atrial Fibrillation and Acute Ischemic Small Vessel Disease
Sook Vui Chong
Department of Internal Medicine, Melaka Manipal Medical College, Malaysia.
Chin Hong Kua
Department of Radiology, Melaka General Hospital, Melaka, Malaysia.
Nan Nitra Than *
Department of Community Medicine, Melaka Manipal Medical College, Malaysia.
*Author to whom correspondence should be addressed.
Abstract
Monoparesis is most commonly caused by dysfunction of the lower motor neurons (LMNs) which innervates the affected limb. This includes lesion affecting the anterior nuclei, ventral nerve roots, lumbosacral plexus, or peripheral nerve. Nevertheless, it can also be due to upper motor neuron lesion, typically seen in lesions of the spinal cord. In general, many conditions that cause hemiplegia, paraplegia or quadriplegia may begin as monoplegia. We illustrate an elderly patient with hypertension, diabetes mellitus, dyslipidemia and atrial fibrillation, who presented with acute monoparesis and radiological evidence suggestive of recent infarct and small vessel disease.
Keywords: Acute monoparesis, hypertension, diabetes mellitus, dyslipidemia, recent infarct, atrial fibrillation, small vessel disease.