Abstract
A 79-year-old man came with a complaint of newly developed right-handed paralysis that had continued for one month. He had a history of left putaminal hemorrhage and had a residual mild movement disorder in his right upper and lower limbs. A finding of right wrist drop was newly revealed, and recurrence of cerebrovascular disease was suspected. Diagnostic imaging test showed no abnormalities indicating new cerebrovascular events. An additional interview revealed that hematochezia had continued for three months. Colonoscopy led to a diagnosis of sigmoid colon cancer. Laparotomy sigmoid resection was performed for his cancer, and physical therapy for the right wrist drop was continued. Two months after the operation, the right wrist drop improved. As a result, the patient was clinically diagnosed with paraneoplastic neurological syndrome. In this case, there was a newly developed neurological deficient symptom. Clinical features that need to be differentiated from cerebrovascular disease are called stroke mimics. Imaging testing did not lead to a diagnosis, but the addition of a closed question contributed to the confirmation of the diagnosis. While cerebrovascular disease is common in the elderly, it is becoming more important to accurately distinguish stroke mimics in neurological acute care.
