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Internal and Emergency Medicine

, Volume 12, Issue 5, pp 675–677 | Cite as

Limb-shaking TIA: on the borders of evidence-based medicine

  • Antonio Carolei
  • Pietro Amedeo ModestiEmail author
CE - COMMENTARY

The case reported by Tiseo et al. [1] underlies the importance of considering and recognizing low cerebral perfusion among the possible causes of jerky unilateral hyperkinetic movements. In this case, the diagnostic difficulty lies in the fact that ischemic brain damage is a common cause of epilepsy in the elderly. A careful history and eyewitness description is crucial to the differentiation of seizures and psychogenic non-epileptic seizures [2].

A wide range of paroxysmal neurological events, linked with a dysfunction in the circuits connecting the cerebral cortex, thalamus, basal ganglia and cerebellum, can be associated with shaking or jerking movements [3, 4]. Any doctor who has managed patients with hyperkinetic involuntary movements knows that the etiological diagnosis of these disorders is a challenging issue that often, despite an extensive diagnostic workup, remains unsolved.

The time course of symptoms and some other elements of the history may provide important clues, and...

Keywords

Celiac Disease Involuntary Movement Moyamoya Disease Carotid Artery Occlusion Paraneoplastic Neurological Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

None.

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Copyright information

© SIMI 2017

Authors and Affiliations

  1. 1.Department of Applied Clinical Sciences and Biotechnology University of L’AquilaL’AquilaItaly
  2. 2.Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly

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