Hyperventilation-induced limb shaking TIA in Moyamoya disease

Abstract

The authors present a case of hyperventilation-induced left upper limb shaking from an underlying Moyamoya disease. Video EEG monitoring and SPECT study were performed. Leptomeningeal collateral circulation was investigated by conventional angiography and by SPECT study with acetazolamide. Limb shaking in Moyamoya disease may result from a transient hypoperfusion of the contralateral frontoparietal cortex rather than basal ganglia.

Regulation of protease‐activated receptor‐1 expression in human buccal fibroblasts stimulated with arecoline

“…We found 38 patients in 27 studies (Supporting Information Table 1),2–28 including 2 patients we previously reported 10, 26. We also found 4 new patients in our medical records from 1985 to 2008.…”

“…The remaining patient had Graves' disease and improved after thyroidectomy 27. In 7 of the 42 patients, the term “dyskinesia” was used for the description of the movement disorders 19–21, 26. All 7 patients suddenly developed dyskinesia repeatedly.…”

“…Up to 6% of patients with MMD may develop various movement disorders, including chorea, dystonia, and dyskinesia, as an initial manifestation or during their clinical courses 2, 3. However, such patients were reported as either a stand‐alone case or in a small series 2–28. As a result, the overall clinical features of movement disorders associated with MMD are not well defined.…”

Hyperventilation-Enhanced Chorea as a Transient Ischaemic Phenomenon in a Patient with Moyamoya Disease

“…A similar case of singing-induced choreatic movements in a moyamoya patient from Korea has recently been reported [16]. Hyperventilation-induced limb-shaking transient ischaemic attacks have also been attributed to a similar pathogenic mechanism, which however caused hypoperfusion of the frontoparietal cerebral cortex in a Korean patient with moyamoya disease [17].…”

Limb-shaking transient ischemic attacks in an adult PHACE syndrome: a case report and review of the literature

“…Limb-shaking TIA has been explained by the ''hypoperfusion theory'', in which carotid stenosis may lead to decrease in cerebral blood flow in critical watershed territories in some situations, especially the dorsolateral frontal cortex [15]. Ischemic damage to the neurons may increase membrane instability, excitatory neurotransmitter release, neuronal excitability, and consequent movement disorders [16].…”