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Limb-shaking carotid transient ischemic attacks successfully treated with modification of the antihypertensive
1Division of Cerebrovascular Diseases, University of Iowa, Iowa City, USA.
Insights
Transient cerebral ischemia can cause involuntary movements, a rare symptom of carotid artery disease. Reducing antihypertensive medication improved a patient
Area of Science:
- Neurology
- Vascular Neurology
- Cerebrovascular Disease
Background:
- Carotid artery occlusive disease can manifest with rare neurological symptoms.
- Transient cerebral ischemia is a potential cause of involuntary episodic movements.
Observation:
- A young man presented with months of daily involuntary right-sided movements.
- The patient had a diagnosed left carotid artery occlusion.
Findings:
- Symptoms significantly improved after a reduction in his antihypertensive medication.
- This suggests a link between blood pressure management and ischemic movement disorders.
Implications:
- Noninvasive management, including medication adjustment, may be an alternative to revascularization for carotid artery disease.
- This case highlights the importance of considering medication effects in patients with unexplained movements.
Abstract:
Involuntary episodic movements associated with transient cerebral ischemia are a rare but well-described presentation of carotid artery occlusive disease. We describe a young man with a left carotid artery occlusion who presented with daily episodes of involuntary movements of the right side that occurred for months. His symptoms virtually disappeared after his antihypertensive drug was reduced. This case supports the possibility of noninvasive management of this condition, which is traditionally treated with revascularization procedures.