Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2022; 10(14): 4569-4573
Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4569
Convulsive-like movements as the first symptom of basilar artery occlusive brainstem infarction: A case report
Ting-Ling Wang, Gang Wu, Su-Zhi Liu
Ting-Ling Wang, Gang Wu, Su-Zhi Liu, Department of Neurology, Taizhou Hospital affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Author contributions: Wang TL collected the clinical data and drafted the initial manuscript; Wu G and Liu SZ revised the article critically; all authors contributed to the intellectual content of this manuscript and approved the final manuscript as submitted.
Supported by National Natural Science Foundations of China, No.81903584.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Su-Zhi Liu, MD, Chief Doctor, Department of Neurology, Taizhou Hospital affiliated to Wenzhou Medical University, No. 150 Ximen Street, Linhai 317000, Zhejiang Province, China. liusz@enzemed.com
Received: September 23, 2021
Peer-review started: September 23, 2021
First decision: November 11, 2021
Revised: November 23, 2021
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: May 16, 2022
Processing time: 231 Days and 19.9 Hours
Abstract
BACKGROUND

Convulsive-like movements are rare in basilar artery occlusive cerebral infarction (BAOCI). These manifestations may easily be mistaken for epileptic seizures caused by compromised anterior circulation or by cortical lesions. Delayed diagnosis of this condition affects its subsequent treatment and prognosis. Therefore, it is critical to recognize this type of phenomenon in the early stage.

CASE SUMMARY

A 55-year-old male patient presented with unconsciousness, rigidity, and a paroxysmal twitch in both lower limbs. These conditions lasted for nearly 2 h and resembled status epilepticus. After the initial conditions subsided, hemiplegia occurred and then subsided rapidly. The family refused thrombolytic therapy because the symptoms were similar to Todd paralysis after epilepsy. However, magnetic resonance imaging showed left pontine infarction. No abnormality was observed in a video electroencephalogram during the interictal period. Digital subtraction angiography revealed that the basilar artery was occluded and that the posterior communicating arteries were patent. Fortunately, the patient received a good prognosis after antiplatelet therapy, lipid regulation, balloon dilatation of the basilar artery, and rehabilitation.

CONCLUSION

Convulsive-like movements may be an early sign of basilar artery occlusive brainstem infarction. It is important to identify this phenomenon in a timely manner.

Keywords: Convulsive-like movements; Basilar artery occlusion; Brainstem infarction; Stroke; Epilepsy; Case report

Core Tip: It is rare for convulsive-like movements to occur as the first symptom of basilar artery occlusive cerebral infarction (BAOCI). When they do occur, however, these movements can serve as an early warning sign of BAOCI. The early diagnosis of basilar artery occlusion can influence patients’ treatment and prognosis.