Limb-shaking transient ischaemic attack

Limb-shaking transient ischaemic attack (LS-TIA) is a symptom of cerebral haemodynamic failure caused by large vessel disease. LS-TIA often remains unrecognised though associated with a poor prognosis. The patient presents with irregular hemiform jerks caused by ischaemia. Imaging demonstrating reduced perfusion or/and flow is essential for the diagnosis, and treatment is aimed at reducing development in atherosclerosis and improving perfusion. As described in this review, management is focused optimising secondary prevention, and in selected cases surgical interventions are considered. Evidence remains weak, especially as to surgical interventions.