Unilateral flapping tremor associated with internal carotid artery stenosis

Obayashi, Tohru; Takeda, Takahiro; Iijima, Makoto; Shimizu, Yuko; Yamada, Hiroshi; Kitagawa, Kazuo

doi:10.1111/ene.13604

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…For instance, in 2018, researchers reported using this system for noninvasive neuromonitoring by obtaining continuous, bilateral TCD recordings in critically ill brain injury patients. Nevertheless, the use of robotic TCD has not been explored among SAH patients [12,13].…”

Section: Introductionmentioning

confidence: 99%

Robotically assisted transcranial Doppler with artificial intelligence for assessment of cerebral vasospasm after subarachnoid hemorrhage

et al. 2020

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Background: Transcranial Doppler (TCD) ultrasound is an essential tool for the detection of cerebral vasospasm after subarachnoid hemorrhage (SAH) but is limited by the availability of skilled operators. We examined the clinical feasibility and concordance of a robotically assisted TCD system with artificial intelligence with routine handheld TCD after SAH. Methods: We evaluated TCD velocities in the anterior cerebral artery (ACA) and middle cerebral artery (MCA) of two patients with high-grade SAH and angiographic evidence of vasospasm. A single channel TCD device with a handheld diagnostic probe as well as a robotically assisted TCD device was used, the relationship of the two tests was evaluated using the bootstrap method of resampling for the concordance correlation coefficient (CCC) paired with a Pearson's correlation analysis, followed by a Bland-Altman plot. Results: Patient 1 developed angiographic and TCD evidence of vasospasm in the proximal right MCA, but except for periods of disorientation remained neurologically intact. Angiographic, TCD and clinical evidence of ACA spasm occurred 6 days after ictus in patient 2. Robotically measured mean flow velocities were comparable to manual TCDs in the MCAs (CCC=0.83; 95% confidence interval [CI], 0.42 to 0.96; P=0.001) but not in the ACAs (CCC=0.26; 95% CI,-0.01 to 0.71; P=0.26). Conclusion: Robotically assisted TCD system with artificial intelligence provides an alternative to manual TCD for assessment of MCA velocities in patients with SAH, expanding the availability of TCD to settings in which specialized clinicians are not available. Further studies for validation of this technology are warranted.

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Section: Introductionmentioning

confidence: 99%

Robotically assisted transcranial Doppler with artificial intelligence for assessment of cerebral vasospasm after subarachnoid hemorrhage

et al. 2020

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“…A total of 82 reports containing 161 cases that developed limb-shaking TIA from 25 countries were reported (Supplementary Material 2, Supplemental Digital Content 1, http://links.lww.com/NRL/A122). 6–87 The origin was European in 63 cases, Asian in 56, North American in 38, South American in 3, and 1 Australian. Figure 2 shows the number of articles published about limb-shaking TIA over time.…”

Section: Resultsmentioning

confidence: 99%

“…Limb-shaking, jerkings, myoclonus ++++++++++ Most common description Asterixis +++ Obayashi et al 70 Khan et al 54 Yoon et al 52 Kaplan et al 87 Hemichorea-hemiballismus ++ Alonso et al 53 25 TIA could not compensate for hypoperfusion due to depleted cerebrovascular reserve capacity. 45 Paroxysmal neurological events are associated with several dysfunctions in the circuits connecting the cerebral cortex, thalamus, basal ganglia, and cerebellum.…”

Section: Descriptionmentioning

confidence: 99%

Limb-Shaking And Transient Ischemic Attack

Pitton Rissardo,

Fornari Caprara

2023

The Neurologist

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Background: Limb-shaking is one of the transient ischemic attacks (TIA) ‘chameleons.’ This literature review aims to evaluate the clinical, epidemiological profile, pathologic mechanisms, and management of limb-shaking TIA. Review Summary: Relevant reports in Medline’s (PubMed) database were identified and assessed by 2 reviewers without language restriction from 1985 to 2022. A total of 82 reports containing 161 cases that developed limb-shaking TIA were reported. The mean and median age were 61.36 (SD: 15.29) and 62 years (range: 4–93 y). Most of the individuals affected were males (64.34%). Limb-shaking was reported as unilateral in 83.33% of the patients. Limb-shaking presented with other neurological deficits in 44.33% of the individuals, in which the most common concurrent neurological deficit was the weakness of at least 1 limb. A recurrence of the “shaking” phenomenon was observed in 83 individuals. A trigger of limb-shaking was reported in 69 cases, and the most common was changing body position. The internal carotid artery was the most frequent vessel involved in limb-shaking. A chronically occluded internal carotid artery was observed in 42 individuals. Hypertension was the most common comorbidity. The management was conservative in 42.30% of the cases. The most frequent misdiagnoses were seizures. A full recovery was achieved in 56.60% of the individuals. Conclusions: Limb-shaking TIA could be defined as involuntary, rhythmic, brief (<5 min), recurrent, jerky movement usually precipitated by activities that may reduce cerebral blood flow. The “shaking” phenomenon was primarily described as a manifestation of symptomatic complete internal carotid artery obstruction.

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Unilateral flapping tremor associated with internal carotid artery stenosis

Cited by 2 publications

References 6 publications

Robotically assisted transcranial Doppler with artificial intelligence for assessment of cerebral vasospasm after subarachnoid hemorrhage

Robotically assisted transcranial Doppler with artificial intelligence for assessment of cerebral vasospasm after subarachnoid hemorrhage

Limb-Shaking And Transient Ischemic Attack

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