Stroke, Vol 16, 444-448, Copyright © 1985 by American Heart Association
GD Baquis, MS Pessin and RM Scott
Eight patients are described with an unusual form of carotid transient
ischemic attack, limb shaking. The basic features included a brief,
involuntary, coarse, irregular, wavering movement or tremble involving
arm-hand alone, or arm-hand and leg together. In 2 patients limb shaking
was the initial manifestation of carotid occlusive disease, and all but one
patient had other typical carotid transient ischemic attacks. Major
atheromatous carotid occlusive disease was present in all patients on the
side opposite the limb movements. Four patients had bilateral carotid
occlusive disease. Cerebral ischemia from a carotid territory low-perfusion
state may be the pathogenesis of these limb movements, an idea supported by
the apparent benefit of surgical revascularization in abolishing or
reducing the limb shaking in 6 patients. There was no clinical or EEG
evidence to document an epileptiform etiology. Recognition of this uncommon
form of carotid transient ischemic attack may be important in the early
diagnosis and treatment of carotid occlusive disease.
ARTICLES
Limb shaking--a carotid TIA
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