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a Department of Neurology, b Department of Internal Medicine, Division of Angiology,
University Hospital, Bern, Switzerland
Correspondence to: Dr Ralf W Baumgartner, Department of Neurology, University Hospital, Frauenklinikstrasse 26, CH-8091 Zurich, Switzerland. Telephone 0041 1 255 56 86; fax 0041 1 255 43 80; email Strusbmg{at}neurol.unizh.ch
Received 30
December 1997 and in revised form 13 March 1998;
Accepted 19 March 1998
OBJECTIVES
To investigate cerebral vasomotor
reactivity in five patients with limb shaking transient ischaemic
attacks by using transcranial Doppler sonography.
METHODAttacks with transient limb shaking were
unilateral in four patients and bilateral in one. Internal carotid
arteries on the side opposite the abnormal limb movements showed three
90-95% stenoses and three occlusions as assessed by cerebral
angiography in three and magnetic resonance angiography and ultrasound
in one case each. Reactivity of cerebral resistance vessels was studied by measuring peak mean velocities in the middle cerebral artery (MCA)
before and after the application of CO2 enriched air.
Reference values were obtained from 25 normal subjects.
RESULTSDuring hypercapnia peak mean velocities
slightly decreased in five MCAs (steal phenomenon) and remained
unchanged in one MCA opposite the abnormal movements, whereas the other
MCAs showed normal reactivities.
CONCLUSIONThe delineation of an exhausted
cerebral vasoreactivity in all hemispheres opposite the involuntary
limb movements suggests that haemodynamic failure is the cause of
transient ischaemic attacks with limb shaking.
This article has been cited by other articles:
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  S. W. Han, S. H. Kim, J. K. Kim, C. H. Park, M. J. Yun, and J. H. Heo Hemodynamic changes in limb shaking TIA associated with anterior cerebral artery stenosis Neurology, October 26, 2004; 63(8): 1519 - 1521. [Abstract] [Full Text] [PDF]
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 U G R Schulz and P M Rothwell Transient ischaemic attacks mimicking focal motor seizures Postgrad. Med. J., April 1, 2002; 78(918): 246 - 247. [Abstract] [Full Text] [PDF]
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 P. W KAPLAN;, R. W BAUMGARTNER, and I. BAUMGARTNER Vasomotor reactivity is exhausted in transient ischaemic attacks with limb shaking J. Neurol. Neurosurg. Psychiatry, July 1, 1999; 67(1): 131 - 132. [Full Text]
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