Pearls & Oy-Sters: Plantar Agraphesthesia in Corticobasal Syndrome.

Abstract

We describe a 70-year-old man with no significant medical history who developed progressive left leg numbness, gait dysfunction, and recurrent falls. Within a year, he reported difficulty with both initiating steps and perceiving his left leg as his own. Neurologic evaluation revealed foot dystonia, bradykinesia, and plantar agraphesthesia. Electromyography and nerve conduction studies were unremarkable. Brain MRI demonstrated asymmetric parietal atrophy, greatest on the right. His symptoms did not improve with high-dose carbidopa-levodopa (900 mg/day). This case highlights plantar agraphesthesia as a valuable bedside sign of lower limb cortical sensory loss, even in the absence of hand involvement.