Some transient ischemic attacks (TIA) may feature limb-shaking. If diagnosed promptly then it allows for interventions that can prevent an acute stroke.

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

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