Effective anticonvulsant therapy in a patient with limb shaking: a case report

A case is described of a patient with limb shaking in whom anticonvulsant therapy was effective for inhibiting attacks. A 70 year old female developed rhythmical involuntary limb shaking of the right upper and lower limb in April 1986. She was diagnosed as having transient ischemic attacks and was followed up under treatment with an antiplatelet drug. Subsequently, anticonvulsant therapy was also initiated on an outpatient basis. In August 1991, she was admitted with shaking of the right upper and lower limbs. Low molecular dextran was ineffective for inhibiting limb shaking attacks, but intravenous injection of diazepam was effective. Phenytoin and phenobarbital was used in combination. No limb shaking attacks occurred thereafter. The involuntary movement was the same as that observed at the onset of the disease. Though no changes were observed in the pattern of the involuntary movement, anticonvulsant therapy was effective in preventing and inhibiting attacks. This finding is inconsistent with previous reports. It is possible that epileptic factors are involved in the development of this condition.