Limb-shaking transient ischemic attack associated with focal electroencephalography slowing: case report

Area of Science:

• Neurology
• Vascular Neurology
• Cerebrovascular Disease

Background:

• Limb shaking is a rare transient ischemic attack (TIA) variant.
• It is often misdiagnosed as focal motor seizures.
• This condition involves involuntary limb movements.

Purpose of the Study:

• To present a case of limb shaking syndrome (LSS).
• To investigate the underlying cause and effective treatment.
• To emphasize the importance of early diagnosis and intervention.

Main Methods:

• Case report of a 61-year-old male patient.
• Diagnostic workup included electroencephalography (EEG) and neuroimaging (MRI, MRA, Doppler ultrasound).
• Surgical intervention: endarterectomy of the internal carotid artery.

Main Results:

• Patient presented with rhythmic left limb jerking, triggered by postural changes and neck extension.
• EEG showed slow activity, but no epileptiform discharges.
• Significant (80%) stenosis of the right internal carotid artery was identified.
• Post-endarterectomy, the patient remained asymptomatic during a 12-month follow-up.

Conclusions:

• LSS may result from cerebral hypoperfusion and reduced vasomotor reactivity.
• Prompt diagnosis of this TIA variant is crucial.
• Surgical correction of carotid stenosis can effectively resolve LSS symptoms and reduce stroke risk.