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Bilateral Limb-Shaking Transient Ischemic Attacks
Brian Behdad Miremadi1, An Tran2, Lara C Wadi3
1Department of Neurology, Harbor-UCLA Medical Center, Torrance, California.
Summary
Bilateral limb-shaking transient ischemic attacks (TIA) are rare, often linked to carotid occlusion. This case highlights a patient whose symptoms resolved with blood pressure management, emphasizing the need for physician awareness.
Area of Science:
- Neurology
- Vascular Neurology
Background:
- Transient ischemic attacks (TIA) are typically associated with unilateral symptoms.
- Carotid artery occlusion is a known cause of TIA, but bilateral presentations are uncommon.
Observation:
- A 69-year-old man experienced recurrent bilateral limb-shaking episodes, triggered by standing.
- These paroxysmal events mimicked seizures or orthostatic hyperkinesia.
Findings:
- Cerebral angiograms confirmed bilateral internal carotid artery occlusion.
- The patient's limb-shaking symptoms significantly improved with targeted blood pressure management.
Implications:
- This case underscores the importance of considering bilateral limb-shaking TIA in patients with unexplained bilateral paroxysmal events.
- Physicians should maintain a high index of suspicion for cerebrovascular causes, even with atypical presentations.
- Effective management of blood pressure may be crucial in resolving such symptoms.
