Ipsilateral eye closure and hemifacial weakness: Useful clinical clue to diagnose pseudostroke

A 16-year-old boy with anxiety was admitted for evaluation of acute-onset left face/hemibody numbness and weakness. Because of the possibility of an acute stroke, he was admitted to an outside hospital and underwent extensive investigations before transfer to our center. On examination, left hemifacial weakness was seen with pulling of the angle of the mouth to the right and left eye closure (video at Neurology.org/cp). CT head, CT perfusion, MRI, and magnetic resonance angiography of the brain did not show any evidence of ischemia or vasculopathy. EEG was normal. Symptoms resolved completely within several weeks with physical therapy aided by psychological counseling and management of anxiety.
Source: Neurology Clinical Practice - Category: Neurology Authors: Tags: Childhood stroke, Clinical neurology examination, Pediatric conversion, Conversion Case Source Type: research