Three middle-aged men with risk factors for vascular disease developed brief, stereotyped hemi-sensory symptoms on sitting or standing. These symptoms occurred in the absence of postural hypotension. On clinical criteria, these episodes were indicative of small vessel (perforator) ischaemia, rather than large vessel disease. This was supported by the absence of any stenosis on duplex scanning of the neck vessels. Two of the patients progressed to develop a fixed deficit. In all 3 patients the outcome was benign, with minimal residual disability.