Limb-shaking TIA: on the borders of evidence-based medicine
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The case reported by Tiseo et al.  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 .
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...
KeywordsCeliac Disease Involuntary Movement Moyamoya Disease Carotid Artery Occlusion Paraneoplastic Neurological Syndrome
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The authors declare that they have no conflict of interest.
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This article does not contain any studies with human participants or animals performed by any of the authors.
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