Limb shaking movement as a rare manifestation of transient ischemic attacks caused by carotid stenosis disease: A case report

A limb shaking TIA is a less common form of TIA that manifests as involuntary movement and is frequently confused with focal motor epilepsy. A 64-year-old female presented with a 7-month history of episodic involuntary shaking movements affecting her left arm and leg before admission. These attacks primarily occurred after she rose from a sitting or lying down position to a standing position, and were relieved by simply returning to a sitting or lying position. A neurological examination revealed no motor or sensory deficits in either extremity. Her magnetic resonance angiogram (MRA) and carotid Doppler revealed right ICA stenosis in her brain. It is important to distinguish this limb shaking TIA from other conditions such as focal motor seizures. Importantly, early detection and treatment of the associated carotid artery occlusion can not only prevent the patient's TIA episode, but also lower the risk of future stroke.