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Isolated Toe Tremor Associated with Antiphospholipid Syndrome.

Biju Gopalakrishnan1, Joseph H Friedman1

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Summary

Antiphospholipid syndrome (APS) can cause neurological issues. This case report details a rare instance of isolated toe tremor as the sole neurological symptom in a woman with APS.

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Area of Science:

  • Neurology
  • Rheumatology
  • Immunology

Background:

  • Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by antiphospholipid antibodies, leading to thrombosis or pregnancy morbidity.
  • Neurological manifestations are common in APS, with stroke being the most frequent, but other autoimmune-related complications like chorea also occur.
  • Isolated neurological symptoms without other typical APS signs are less commonly reported.

Observation:

  • A case of recurrent, isolated, unilateral toe tremor is presented in an otherwise healthy woman.
  • The patient had a long-standing diagnosis of Antiphospholipid Syndrome (APS).
  • No other neurological signs or symptoms were present, distinguishing it from typical APS-related neurological deficits.

Findings:

  • This report describes the first known case of isolated toe tremor as the sole neurological manifestation of Antiphospholipid Syndrome (APS).
  • The tremor was unilateral and recurrent, presenting without other associated neurological or systemic APS features.
  • This finding expands the spectrum of potential neurological complications associated with APS.

Implications:

  • Clinicians should consider Antiphospholipid Syndrome (APS) in the differential diagnosis of isolated neurological symptoms, such as toe tremor.
  • Further research is needed to understand the mechanisms linking APS to rare neurological presentations.
  • Recognition of such atypical presentations can lead to earlier diagnosis and management of APS-related complications.