Isolated Wrist Drop as the Sole Presentation of an Acute Embolic Ischemic Stroke

Stroke is a major public health concern and a leading cause of morbidity and mortality worldwide. It often presents with a wide range of neurological deficits based on the neuroanatomical locus of the insult. Symptoms widely vary and usually occur in concordance with the distribution of the homunculus. Although rare, stroke can present with isolated wrist drop, which creates a diagnostic dilemma owing to the fact that this condition is by far more commonly caused by peripheral lesions. Moreover, localizing the site of injury is crucial for guiding therapeutic management and determining the overall prognosis of the condition. We present a 73-year-old patient with an isolated central wrist drop caused by an embolic ischemic stroke that was initially confused for a lower motor neuron pathology affecting the radial nerve.