Bilateral asymmetrical asterixis as limb-shaking transient ischemic attack in bilateral carotid stenosis

Shaida Khan, Eric Chang, Georgia Saniuk, Ty Shang

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Asterixis as limb-shaking transient ischemic attack (TIA) is rare and poorly understood. Bilateral asymmetrical asterixis as limb-shaking TIA has not been reported in carotid stenosis. A 69-year-old gentleman presented with a TIA episode (dysarthria, right-Arm weakness, and numbness). Bilateral asterixis was observed and was more severe on the right side. No prior infarcts were noted in the thalamus. Liver function was normal. A computerized tomography angiogram revealed 85%stenosis of the right internal carotid artery (ICA) and 65% stenosis of the left ICA. Three days after left ICA endarterectomy, the patient had complete disappearance of bilateral asterixis, with the right side showing initial improvement. The bilateral asterixis observed is proposed to be secondary to hemodynamic impairment and hypoperfusion of certain brain territory with resolution on revasculari-zation.

Original languageEnglish (US)
Pages (from-to)e29-e30
JournalJournal of Stroke and Cerebrovascular Diseases
Volume24
Issue number1
DOIs
StatePublished - Jan 1 2015

Keywords

  • Carotid stenosis
  • asterixis
  • carotid endarterectomy
  • limb shaking TIA

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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