Cortical shoulder syndrome: isolated shoulder weakness from a small cortical infarct
A 62-year-old right-handed man was seated at home at 01.00 hour when he noticed numbness ("like a cold touch") over the right lateral shoulder. There was no initial weakness. He went to bed, but on waking at 08.00 hour, he could not lift his right shoulder. He came by ambulance to the hospital. He took salbutamol as needed for asthma but had no history of hypertension, diabetes or dyslipidaemia. He worked as a handyman, regularly smoked tobacco, occasionally took amphetamines and drank beer heavily (10–20 alcohol units daily).
On examination, he looked well, with no gait deficit. There was moderate right shoulder abduction weakness (figure 1) and subtle right elbow extension weakness. Elbow flexion, wrist extension, finger flexion/extension and thumb opposition were normal (MRC 5/5). There was an altered sensation ‘like a cold touch’ to light touch and pinprick on the right lateral shoulder, over the deltoid, extending to the...
Source: Practical Neurology - Online First Published 12 Nov 2026 Imported 12 Nov 2026 Relevancy: Not reviewed
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