Inducible limb-shaking transitory ischemic attacks: A video-documented case report and review of the literature

TY - JOUR

T1 - Inducible limb-shaking transitory ischemic attacks

T2 - A video-documented case report and review of the literature

AU - Rosenbaum, Sverre

AU - Ovesen, Christian

AU - Futrell, Nancy

AU - Krieger, Derk W.

PY - 2016

Y1 - 2016

N2 - Background: Limb-shaking transient ischemic attack (TIA) is a well-recognized, but rare observation in contralateral carotid steno-occlusive disease. Consequently, most clinicians have not had the chance to witness an attack. Case presentation: We present the story of a 64-year old gentleman with exercise-induced weakness associated with tremor in his right arm. His left internal carotid artery was occluded at the bifurcation. Administration of statin and antiplatelet did not relieve his symptoms, and his stereotypic, exercise-induced "limb-shaking" episodes persisted. He underwent successful extracranial to intracranial (EC-IC) bypass, which stopped his symptoms. The patient, however, returned to our department and reported that he was able to recreate his original symptoms by compressing the bypass graft manually. Conclusion: To our knowledge, this is the first case with video documentation of the clinical appearance of a limb-shaking TIA. We hope this case report will increase the physicians' understanding of the clinical nature of limb-shaking TIAs.

AB - Background: Limb-shaking transient ischemic attack (TIA) is a well-recognized, but rare observation in contralateral carotid steno-occlusive disease. Consequently, most clinicians have not had the chance to witness an attack. Case presentation: We present the story of a 64-year old gentleman with exercise-induced weakness associated with tremor in his right arm. His left internal carotid artery was occluded at the bifurcation. Administration of statin and antiplatelet did not relieve his symptoms, and his stereotypic, exercise-induced "limb-shaking" episodes persisted. He underwent successful extracranial to intracranial (EC-IC) bypass, which stopped his symptoms. The patient, however, returned to our department and reported that he was able to recreate his original symptoms by compressing the bypass graft manually. Conclusion: To our knowledge, this is the first case with video documentation of the clinical appearance of a limb-shaking TIA. We hope this case report will increase the physicians' understanding of the clinical nature of limb-shaking TIAs.

KW - Carotid occlusion

KW - EC-IC bypass

KW - Limb-shaking TIA

KW - Stroke

U2 - 10.1186/s12883-016-0601-8

DO - 10.1186/s12883-016-0601-8

M3 - Journal article

C2 - 27215317

AN - SCOPUS:85007591263

SN - 1471-2377

VL - 16

JO - BMC Neurology

JF - BMC Neurology

IS - 1

M1 - 78

ER -