Abstract
An 83-year-old right-handed woman with coronary artery disease (CAD) was admitted due to acute-onset confusion, visual impairment, and right-sided paresis. Upon admission, the patient was lethargic and disorientated in terms of time and place. The visual field examination revealed right-sided homonymous hemianopsia, and the motor examination revealed paralysis on the right side (which was of grade 4 according to the medical research council). She also had the grasp reflex on her left hand. A Cranial magnetic resonance imaging (MRI) scan revealed acute infarction in the territory of the left posterior cerebral artery (PCA) ([Figure 1]). On the second day of follow-up, the patient developed ipsilateral involuntary movements of her left hand and foot that were compatible with the tremor-like grasp phenomenon ([Video 1]).[1] [2] Of note, a routine electroencephalogram (EEG) did not show an epileptiform discharge. The movements were fully recovered one week later without additional interventions. We herein report a very rare entity of a motor symptom ipsilateral to an acute brain injury that has been hypothesized to be due to hyperexcitation of the frontal lobe, contralateral to the movements.[2]
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