A Rare Presentation of a Patient with Limb-Shaking TIA due to Severe Carotid Artery Stenosis

Abstract

Background: A limb-shaking Transient Ischemic Attack (TIA) is a rare neurological symptom of hemodynamic origin caused by severe carotid artery disease. Physicians should be aware of its presence because it has a non-typical presentation and is cured by endarterectomy or stenting of the stenosed carotid artery. The aim of the present study was to describe a rare case of limb-shaking TIA.
Description of case: A 76 year-old man with a 80% right internal carotid artery stenosis presented with numerous episodes of involuntary jerky movements of his left arm and leg, associated with episodes of brief weakness of the left leg, caused by preoperative optimization of his hypertension. No stroke ensued despite the daily appearance of symptoms for several months. Limb-shaking TIA was diagnosed and all symptoms disappeared immediately after an uncomplicated carotid endarterectomy was performed.
Conclusion: The clinical presentation of this limb-shaking TIA case, the first to our knowledge to appear during treatment of hypertension, supports further the hemodynamic theory of limb shaking TIAs.