Reader Response: Clinical Reasoning: A 70-Year-Old Man With Right Arm and Leg Shaking

The authors describe a case of a 70-year-old man presenting with increased right arm flexion, right leg extension, and limb shaking ischemic events because of an atypical anterior cerebral artery (ACA) stroke in concurrence with normal vital signs.1 We agree with the concluded localization of the stroke. However, serial focal motor seizures, focal-impaired awareness seizures, or status epilepticus with acute stroke may be more likely explanations of the event than limb shaking ischemic events and an akinetic mutism resulting in seizure mimicry.

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