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. 2022 Feb;6(1):1-7.
doi: 10.5811/cpcem.2022.2.55676.

57-year-old Female with Unusual Left-arm Movements

Christina M Powell  1   1   2   3 , Lauren S Rosenblatt  2   1   2   3 , Laura J Bontempo  2   1   2   3 , Zachary D W Dezman  2   3   1   2   3
Affiliations

57-year-old Female with Unusual Left-arm Movements

Christina M Powell et al. Clin Pract Cases Emerg Med. 2022 Feb.

Abstract

Introduction: A 57-year-old, right-hand dominant female presented to the emergency department striking herself with her left hand.

Case presentation: The astute medical staff looked beyond a behavioral health etiology. A detailed history, physical examination, and workup reveals the fascinating final diagnosis.

Discussion: This case takes the reader through the differential diagnosis and systematic workup of uncontrolled limb movements with discussion of the studies which ultimately led to this patient's diagnosis.

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Conflict of interest statement

Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Figures

Image 1
Image 1
Clock drawn with the dominant (right) hand of a 57-year-old female presenting with strange movements and shaking of her left arm.
Image 2
Image 2
Computed tomography angiography of the neck identifying soft tissue at the right carotid bulb (arrow), mildly narrowing the lumen by less than 50%, potentially composed of soft atherosclerotic plaque with extensive thrombus.
Image 3
Image 3
Brain magnetic resonance imaging showing (A) multiple foci of abnormal restricted diffusion predominantly involving the right parietal lobe (arrows) and right occipital lobe (arrowhead), and (B) hyperintense signal of the right parietal lobe on axial T2 fluid attenuated inversion recovery (FLAIR) sequence (arrow).
See this image and copyright information in PMC

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