Involuntary episodic movements associated with transient cerebral ischemia are a rare but well-described presentation of carotid artery occlusive disease. We describe a young man with a left carotid artery occlusion who presented with daily episodes of involuntary movements of the right side that occurred for months. His symptoms virtually disappeared after his antihypertensive drug was reduced. This case supports the possibility of noninvasive management of this condition, which is traditionally treated with revascularization procedures.

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