Unilateral arm flapping gait as a manifestation of synkinesis following recurrent strokes

A 67-year old woman with a history of mitral valve replacement 11 years ago, and the development of left hemiparesis 5 years previously, was admitted to our hospital because of the development of mild right hemiparesis; the brain magnetic resonance imaging (MRI) revealed acute infarcts in the left frontoparietal lobes and encephalomalacia in the right frontotemporal area and left cerebellum. [7] However, the left arm of this patient levitated in supination with elbow flexion,[7] whereas our patient exhibited straight arm elevation. The authors of the case report hypothesized that the motor cortex representing the arm movements might have been activated instead of the motor cortex representing the leg movements; or, the activated motor cortex responsible for the leg movements might have been wrongly connected to the subcortical white matter tracts that originally served the arm movements due to neuronal misconnections in the cortico-striato-thalamic pathway after the development of stroke.