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Related Experiment Videos

Orthostatic-mediated hypoperfusion in limb-shaking transient ischemic attack

A Khan1, V Beletsky, R Kelley

  • 1Department of Neurology, Louisiana State University, Medical Center, Shreveport, LA 71130-3932, USA.

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|January 29, 1999
PubMed
Summary

Episodic limb shaking in severe carotid artery disease is likely due to cerebral hypoperfusion, not seizures. This case highlights reduced cerebrovascular reserve in total carotid occlusion causing contralateral motor dysfunction.

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Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Severe carotid stenosis or occlusion can cause neurological symptoms.
  • Distinguishing between hypoperfusion and epileptogenic activity is crucial for diagnosis.

Observation:

  • A patient presented with orthostatic-mediated, right-sided limb shaking.
  • The patient had a total left internal carotid artery occlusion.

Findings:

  • Single photon emission computed tomography (SPECT) showed reduced cerebrovascular reserve.
  • Transcranial Doppler (TCD) revealed decreased middle cerebral artery flow in the upright position, unrelated to electroencephalographic monitoring.
  • Limb shaking episodes were attributed to contralateral cerebral hemisphere hypoperfusion.

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Implications:

  • This case supports hypoperfusion as a cause of episodic motor dysfunction in carotid occlusion.
  • It emphasizes the importance of assessing cerebrovascular reserve in such patients.
  • Findings suggest that limb shaking may not always indicate epileptogenic activity in this context.