ABSTRACT
Limb-shaking transient ischemic attack (TIA), a rare manifestation, is commonly caused by severe stenosis or occlusion of an extracranial internal carotid artery. Such patients are usually treated with surgical revascularization or anti-platelet therapy. We present a 56-year-old woman with 6 months’ episodic attacks starting with mouth skewed to the right and a sensation of ‘weakness’ involving predominantly her left arm, and at times, also involved the left leg. This was immediately followed by rhythmic jerky movements of the left arm and at times, also involved the left leg. Magnetic resonance angiography revealed severe stenosis of M1 segment of the right middle cerebral artery. The patient’s symptoms were signifi cantly improved by treatment with anti-platelet drugs and nimodipine.