Bilateral Asymmetrical Asterixis as Limb-shaking Transient Ischemic Attack in Bilateral Carotid Stenosis

Khan, Shaida; Chang, Eric; Saniuk, Georgia; Shang, Ty

doi:10.1016/j.jstrokecerebrovasdis.2014.08.016

Cited by 9 publications

(9 citation statements)

References 6 publications

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“…However, this case was unique in that an ischemic focus was detected in the corona radiate. This differs from previous reports of similar cases documenting lesions involving the thalamus (in the majority of cases), frontal cortex, striatum, midbrain and cerebellum [2][3][4][5][6]. The lack of paroxysmal waves detected with EEG probably suggests that the limb-shaking symptom is not epileptic.…”

Section: E T T E R T O T H E E D I T O Rcontrasting

confidence: 99%

Unilateral flapping tremor associated with internal carotid artery stenosis

Obayashi

Takeda

Iijima

et al. 2018

Euro J of Neurology

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Section: E T T E R T O T H E E D I T O Rcontrasting

confidence: 99%

Unilateral flapping tremor associated with internal carotid artery stenosis

Obayashi

Takeda

Iijima

et al. 2018

Euro J of Neurology

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“…2,[5][6][7][8] Some reports indicated that revascularization, such as carotid endarterectomy (CEA) and extracranial-intracranial anastomosis, improved LS-TIA symptoms. 8,[13][14][15]…”

Section: Discussionmentioning

confidence: 99%

“…7,[9][10][11][12] Moreover, there have been only a few reports of LS-TIA resolution via surgical revascularization procedures. 8,[13][14][15] Here, we report a case of MMD presenting with LS-TIA in the upper limb, which improved after superficial temporal artery (STA) MCA anastomosis and encephalo-duro-myo-arterio-pericranial synangiosis (EDMAPS). 16 The patient subsequently developed LS-TIA in the lower limb due to ACA occlusion, which was treated using the multiple burr hole opening (MBHO) procedure.…”

mentioning

confidence: 98%

Successful multiple burr hole openings for limb-shaking transient ischemic attack due to moyamoya disease: illustrative case

Ikeuchi

Ashida

Nishihara

et al. 2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Limb-shaking transient ischemic attacks (LS-TIAs) are a rare form of TIAs that present as involuntary movements of the limbs and indicate severe cerebral hypoperfusion. LS-TIAs are often reported in patients with carotid artery stenosis but can also affect patients with intracranial artery stenosis and moyamoya disease (MMD). OBSERVATIONS A 72-year-old woman presented with repeated episodes of involuntary shaking movements of the right upper limb. Cerebral angiography revealed complete occlusion of the M1 segment of the left middle cerebral artery (MCA), and the left hemisphere was supplied by moyamoya vessels. She was treated with left direct revascularization without complications, and her involuntary movements subsided. However, she demonstrated involuntary shaking movements of the right lower limb 2 months postoperatively. Cerebral angiography revealed complete occlusion of the A1 segment of the left anterior cerebral artery (ACA). The multiple burr hole opening (MBHO) procedure was performed to improve perfusion in the left ACA territory and after 3 months, the patient’s symptoms resolved. LESSONS This case demonstrated that LS-TIAs can also develop as ischemic symptoms due to MMD. Moreover, instances of LS-TIA of the upper and lower limbs developed separately in the same patient. The patient’s symptoms improved with direct revascularization and MBHO.

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“…[7] In addition, presenta- tion as a hyperkinetic movement disorder, such as hemiballismus-hemichorea, asterixis or ortosthatic tremor, may lead to diagnostic confusion. [8][9][10] However, short duration, subsequent paresis or numbness, and precipitation by factors affecting hemodynamic stability suggest a vascular lesion. [2,5,6] It is usually reported in cases of severe stenosis or occlusive disease of carotid artery, [2][3][4]9] but there are also reports with lesions of middle cerebral artery (MCA) and anterior cerebral artery (ACA).…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10] However, short duration, subsequent paresis or numbness, and precipitation by factors affecting hemodynamic stability suggest a vascular lesion. [2,5,6] It is usually reported in cases of severe stenosis or occlusive disease of carotid artery, [2][3][4]9] but there are also reports with lesions of middle cerebral artery (MCA) and anterior cerebral artery (ACA). [11][12][13] Critical stenosis was not observed in this case; however, patient had dissection of ICA.…”

Section: Discussionmentioning

confidence: 99%

Limb Shaking Secondary to Carotid Artery Dissection: Case Report

Erturk¹

2016

Epilepsi

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Özet'Limb Shaking' üst veya alt ekstremitelerin, istemsiz, ritmik veya disritmik, geçici ve genelde kaba olan titreme hareketidir. Burada ani başlangıçlı sol taraflı uyuşma ve güçsüzlük yakınması ile başvuran; öyküsünde bir ay öncesinde de sol kolunda titreme hareketi sonrasında gelişen benzer bir geçici atağı olan 47 yaşında bir erkek hasta sunulacaktır. Kraniyal manyetik rezonans görüntülemesinde multipl akut ve subakut enfarktları saptanan hastanın serebral anjiyografisinde karotis arter diseksiyonu saptanmış olup oral antikoagülan tedavi ile takibe alınmış ve altı aylık izlemde yeni yakınma gözlenmemiştir. 'Limb shaking' karotis arter hastalığının bir belirtisi olup ciddi enfarktlar ile sonuçlanabilmektedir. Nadir karşılaşılan bu semptomun tanınması, vasküler olaya uygun tedavi başlanması açısından önem taşımaktadır.

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Bilateral Asymmetrical Asterixis as Limb-shaking Transient Ischemic Attack in Bilateral Carotid Stenosis

Cited by 9 publications

References 6 publications

Unilateral flapping tremor associated with internal carotid artery stenosis

Unilateral flapping tremor associated with internal carotid artery stenosis

Successful multiple burr hole openings for limb-shaking transient ischemic attack due to moyamoya disease: illustrative case

Limb Shaking Secondary to Carotid Artery Dissection: Case Report

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