L. Niehaus et al., TRANSIENT VISUAL BLURRING, RETRO-ORBITAL PAIN AND REPETITIVE INVOLUNTARY MOVEMENTS IN UNILATERAL CAROTID-ARTERY OCCLUSION, Clinical neurology and neurosurgery, 100(1), 1998, pp. 31-32
An 83-year-old man presented with episodes of right sided retro-orbita
l pain, visual disturbance, involuntary jerks of his left arm and less
frequently his left leg. The symptoms could be triggered by exercise,
heat or cough. EEG recordings revealed no epileptic discharges. Duple
x ultrasonography showed an occlusion of the right internal carotid ar
tery. Blood flow velocity in the right middle cerebral artery was redu
ced and vasomotor reactivity to hypercapnia was absent. Reduction of h
is antihypertensive medication rendered the patient asymptomatic. The
combination of transient visual blurring, retro-orbital pain and contr
alateral limb shaking can be an unusual manifestation of carotid occlu
sive disease. In such a case, the symptoms may be managed successfully
by the elevation of blood pressure. (C) 1998 Elsevier Science B.V. Al
l rights reserved.