His stroke work-up included a transthoracic echocardiogram and a carotid Doppler that were unremarkable. Also, advanced notification of stroke teams by EMS shortens the time to initial evaluation by physicians and increases the likelihood of alteplase use. This patient had an unusual and disturbing manifestation of uncontrolled involuntary genital fondling with the nondominant, apraxic hand and with mirroring hand movements during eating. A stroke team should be ready to assess the patient in the ED once the patient arrives. Email Jumpstart.
His stroke work-up included a transthoracic echocardiogram and a carotid Doppler that were unremarkable. For example, the patient tended to simultaneously bring both hands to his mouth when eating, one holding a piece of chicken and the other holding the fork. A similar prolonged reaction time on the affected side was demonstrated in a recent motor control study of wrist movements in a patient with AHS.