Limb-Shaking TIA Presenting as Hemichorea-Hemiballismus: TIA Chameleons Diagnostic Challenge in the Emergency Department

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
Joaquin Valle AlonsoElisa Lopera

Abstract

demonstrate the importance of considering limb-shaking syndrome in the differential diagnosis of patients who present to the emergency department (ED) with hyperkinetic movements. In this article, we describe a diagnostic challenge in the ED in which a patient presents with hyperkinetic movements that are initially diagnosed as hemichorea-hemiballismus (HCHB) but are subsequently found to be limb-shaking syndrome with important therapeutic opportunities. Following a diagnosis of left carotid obstruction, the patient underwent left carotid endarterectomy 5 days after admission. Six months after surgery, the patient had no further symptoms, and an ultrasound scan and magnetic resonance angiography have confirmed no restenosis. Limb shaking is an uncommon form of transient ischemic attack that should be recognized and differentiated from conditions such as focal motor seizures. Recognition will almost invariably indicate carotid artery occlusion, and timely treatment may not only abolish the attacks in patients but also reduce their risk of stroke. HCHB represents a spectrum of hyperkinetic movement disorders varying in the severity of choreic and/or ballistic movements. The presented case includes limb-shaking syndrome in the dif...Continue Reading

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Citations

Sep 22, 2018·Current Opinion in Neurology·Solène Moulin, Didier Leys
Apr 18, 2020·Practical Neurology·Sacha E GandhiVicky L Marshall
Feb 24, 2017·Current Neurology and Neuroscience Reports·Ava L Liberman, Shyam Prabhakaran
Jun 4, 2019·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·D A DeminE V Nikolaeva
Jan 13, 2018·Der Nervenarzt·J S BecktepeG Deuschl
Apr 28, 2021·Neurology India·Priyanka Tater, Sanjay Pandey

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