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EM@3AM: Cortical Hand-Knob Stroke Mimicking Peripheral Nerve Injury

A 95-year-old man presents after waking with sudden inability to move the fingers and thumb of his right hand. He can lift his arm, flex and extend his wrist normally, and reports intact sensation. He denies numbness, facial droop, dysarthria, headache, gait disturbance, chest pain, or dyspnea. He has 0/5 strength in finger flexion and extension as well as in the intrinsic hand musculature, with preserved proximal upper extremity strength and intact sensation. He has no other appreciable deficits and normal vital signs. What is the diagnosis?

Articles

FOAMED, FOAMTOX, TOXCards

ToxCard: Chloramphenicol Toxicity

April 29, 2026
Nabihah Kumte
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How should you manage chloramphenicol toxicity?

emDOCs Podcast – Episode 139: EBM Acute Appendicitis in Adults Part 2

April 27, 2026
Brit Long
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We're back with Part 2 on EBM updates concerning the imaging and management of adult appendicitis.

ECG Pointers: Baclofen

April 22, 2026
Lloyd Tannenbaum
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Dr. Tannenbaum covers a case of baclofen toxicity in today's ECG Pointers.

US Probe: Serratus Anterior Block

April 20, 2026
Sophia Potalivo
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When, how, and why should you perform the serratus anterior block?

Journal Feed Weekly Wrap-Up

April 18, 2026
Clay Smith
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Journal returns with spacers for pediatric wheezing, observation duration after epinephrine for anaphylaxis, and DOAC choice in VTE.

emDOCs Podcast – Episode 138: EBM Acute Appendicitis in Adults Part 1

April 13, 2026
Brit Long
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The emDOCs Podcast covers EBM Updates in the adult patient with appendicitis, specifically history and exam, lab testing, and diagnostic scoring systems.

High lateral OMI

Elevation in I, aVL, +/- V2 with depression in inferior leads, especially III (South African Flag sign); occlusion of first diagonal branch or left circumflex artery