Pathology: diminished perfusion of the frontosubcortical motor pathways
Conditions associated with limb-shaking TIA:
(1) carotid artery stenosis
(2) dissection or stenosis of the middle cerebral artery
(3) stenosis of the brachiocephalic artery
Features of the movement disorder:
(1) involuntary, repetitive and stereotyped trembling and shaking of the limbs
(2) postural (worse after standing quickly; better if lying down)
(3) tends to affect the upper limbs
(4) tends to spare facial muscles
(5) usually unilateral on the side opposite to the implicated artery
Differential diagnosis:
(1) epilepsy
(2) other movement disorders
