Number: 161
Article type: Literature Review
Article title: Limb-Shaking And Transient Ischemic Attack: A Systematic Review
Journal: The Neurologist
Year: 2023
Authors: Jamir Pitton Rissardo, Ana LetÃcia Fornari Caprara
E-mail: jamirrissardo@gmail.com
ABSTRACT
Background: Limb-shaking is one of the transient ischemic attacks (TIA) 'chameleons.' This literature review aims to evaluate the clinical, epidemiological profile, pathologic mechanisms, and management of limb-shaking TIA. Review summary: Relevant reports in Medline's (PubMed) database were identified and assessed by 2 reviewers without language restriction from 1985 to 2022. A total of 82 reports containing 161 cases that developed limb-shaking TIA were reported. The mean and median age were 61.36 (SD: 15.29) and 62 years (range: 4-93 y). Most of the individuals affected were males (64.34%). Limb-shaking was reported as unilateral in 83.33% of the patients. Limb-shaking presented with other neurological deficits in 44.33% of the individuals, in which the most common concurrent neurological deficit was the weakness of at least 1 limb. A recurrence of the "shaking" phenomenon was observed in 83 individuals. A trigger of limb-shaking was reported in 69 cases, and the most common was changing body position. The internal carotid artery was the most frequent vessel involved in limb-shaking. A chronically occluded internal carotid artery was observed in 42 individuals. Hypertension was the most common comorbidity. The management was conservative in 42.30% of the cases. The most frequent misdiagnoses were seizures. A full recovery was achieved in 56.60% of the individuals. Conclusions: Limb-shaking TIA could be defined as involuntary, rhythmic, brief (<5 min), recurrent, jerky movement usually precipitated by activities that may reduce cerebral blood flow. The "shaking" phenomenon was primarily described as a manifestation of symptomatic complete internal carotid artery obstruction.
Keywords: stroke; cerebrovascular disease; carotid artery disease; movement disorder; literature review.
Full text available at:
DOI
10.1097/NRL.0000000000000526
Citation
Pitton Rissardo J, Fornari Caprara AL. Limb-Shaking And Transient Ischemic Attack: A Systematic Review. Neurologist 2024;29:126-132. doi: 10.1097/NRL.0000000000000526.
Figure 1. Flowchart of the screening process.
Figure 2. Graphic showing the number of clinical reports of limb-shaking and transient ischemic attack from 1985 to 2022.
Table 1. Limb-shaking transient ischemic attack descriptions in the literature.
Table 2. Clinical clues in limb-shaking transient ischemic attack.