- 作者：Joaquin Valle Alonso ; MD&lowast ; ; joa51274@hotmail.com" class="auth_mail" title="E-mail the corresponding author ; Francisco Javier Fonseca del Pozo ; MD ; PhD&dagger ; ; Jesú ; s Carmona Simó ; n ; MD&Dagger ; ; Saray Valenzuela ; MD§ ; ; Francisca Perez Gomez ; MD&Dagger ; ; Elisa Lopera ; MD鈥?/sup>
- 关键词：TIA ; limb shaking ; hemichorea&ndash ; hemiballismus ; carotid stenosis ; hyperkinetic movements ; stroke
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：2015
- 出版时间：November 2015
- 年：2015
- 卷：24
- 期：11
- 页码：e327-e331
- 全文大小：651 K
Methods
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.
Results
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.
Conclusion
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 differential diagnosis and prompts for further investigations to complete the assessment.