Background: Limb-shaking is one of the transient ischemic attacks (TIA) 'chameleons.' This literature review aims to evaluate the clinical, epidemiological profile, pathologic mechanisms, and management of limb-shaking TIA.
Review Summary: Relevant reports in Medline's (PubMed) database were identified and assessed by 2 reviewers without language restriction from 1985 to 2022. A total of 82 reports containing 161 cases that developed limb-shaking TIA were reported. The mean and median age were 61.36 (SD: 15.29) and 62 years (range: 4-93 y). Most of the individuals affected were males (64.34%). Limb-shaking was reported as unilateral in 83.33% of the patients. Limb-shaking presented with other neurological deficits in 44.33% of the individuals, in which the most common concurrent neurological deficit was the weakness of at least 1 limb. A recurrence of the "shaking" phenomenon was observed in 83 individuals. A trigger of limb-shaking was reported in 69 cases, and the most common was changing body position. The internal carotid artery was the most frequent vessel involved in limb-shaking. A chronically occluded internal carotid artery was observed in 42 individuals. Hypertension was the most common comorbidity. The management was conservative in 42.30% of the cases. The most frequent misdiagnoses were seizures. A full recovery was achieved in 56.60% of the individuals.
Conclusions: Limb-shaking TIA could be defined as involuntary, rhythmic, brief (<5 min), recurrent, jerky movement usually precipitated by activities that may reduce cerebral blood flow. The "shaking" phenomenon was primarily described as a manifestation of symptomatic complete internal carotid artery obstruction.
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http://dx.doi.org/10.1097/NRL.0000000000000526 | DOI Listing |
World Neurosurg
November 2024
Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China. Electronic address:
A rare presentation of unilateral carotid rete mirabile (RM) in a 70-year-old male manifesting as limb-shaking transient ischemic attacks, a disorder typically associated with carotid artery stenosis. The patient experienced recurrent left-sided limb shaking and numbness, with angiography revealing an anomalous microarterial collateral network replacing the right internal carotid artery's cavernous segment, indicative of RM. Differential diagnoses included recanalization following occlusion, arteriovenous malformation, with carotid canal dysplasia on computed tomography supporting the RM diagnosis.
View Article and Find Full Text PDFBMJ Case Rep
October 2024
Neurology, Northampton General Hospital NHS Trust, Northampton, Northamptonshire, UK.
Chorea is a hyperkinetic movement disorder characterised by involuntary, brief, random and irregular contractions. Acquired chorea can present acutely or subacutely and may be asymmetrical or unilateral. A detailed history and examination are crucial to identify triggering factors and underlying cause.
View Article and Find Full Text PDFEJNMMI Res
October 2024
Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Limb-shaking transient ischemic attack (TIA) is a rare manifestation of carotid-occlusive damage. This case report highlights the importance of accurate diagnosis and treatment of bilateral ballism as limb-shaking TIA. Superficial cephalic artery and mid-large artery anastomosis was performed after the initial acute treatment, and involuntary limb shaking disappeared.
View Article and Find Full Text PDFCyborg Bionic Syst
June 2024
University College London, London, UK.
Rehabilitation robots can reproduce the rehabilitation movements of therapists by designed rehabilitation robot control methods to achieve the goal of training the patients' motion abilities. This paper proposes an impedance sliding-mode control method based on stiffness-scheduled law for the rehabilitation robot, which can be applied to rehabilitation training with both active and passive modes. A free-model-based sliding-mode control strategy is developed to avoid model dependence and reduce the system uncertainty caused by limb shaking.
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