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Prolonged ictal amnesia with transient focal abnormalities on magnetic resonance imaging.

A previously healthy woman had a prolonged amnestic state caused by complex partial status epilepticus with bilateral mesiotemporal lobe involvement confirmed by EEG with nasopharyngeal electrodes. A magnetic resonance imaging (MRI) scan obtained shortly after recovery from the amnesia showed reversible focal abnormalities consisting of increased signal intensity on T2-weighted scan in the mesiotemporal lobe.

Adult↗

Reversible amnesia associated with a left temporal hematoma in a case of right temporal complex partial seizures.

We report the case of a 44-year-old woman with complex partial seizures (CPS) of right frontotemporal origin who developed generalized amnesia after undergoing intracranial electrode implantation complicated by left hippocampal hemorrhage. Serial memory testing disclosed recovery from the amnesic disorder, while repeated magnetic resonance imaging (MRI) showed resolution of her left hippocampal hemorrhage in a 2-month period. A second intracarotid amytal procedure confirmed the capability of her left temporal region to support memory. Consequently, a right orbitofrontotemporal lobectomy was performed without complication.

Adult↗

Unilateral temporal lobe stroke causing ischemic transient global amnesia: role for diffusion-weighted imaging in the initial evaluation.

Ischemia has been proposed as a cause of transient global amnesia (TGA), but proof has been lacking. The authors performed magnetic resonance imaging on a 77-year-old woman with classic TGA at 4 hours and at 6 days after the onset of symptoms. Her initial diffusion-weighted imaging (DWI) and apparent diffusion coefficient imaging suggested an acute infarct in the left mesial temporal lobe. Follow-up T2-weighted imaging at 6 days confirmed the lesion as an ischemic infarct, despite resolution of her symptoms. DWI permits early detection of small ischemic lesions and may identify patients with ischemic TGA who should be evaluated for potential sources of emboli.

Aged↗

Transient global amnesia as a manifestation of transient cerebral ischemia.

Ten patients with transient global amnesia (TGA) associated with symptoms of transient focal cerebral ischemia were seen at the University Department of Neurology, Arhus Kommunehospital in the period 1966-1978. All had either prior to or following the amnesic attack transient ischemic attacks (TIA) in the territory of the posterior cerebral circulation. On admission minor neurological deficits were noted in three and normal findings in the remaining seven. There was no evidence of epilepsy in any case. We studied the course (average, 77 months) and found that three had recurrent amnesic episodes. Four patients had only further transient focal cerebral ischemic attacks, while six developed a completed stroke, in five located in the distribution of the basilar artery. Seven patients had persistent memory impairment. TGA is one manifestation of TIA in the vertebrobasilar arterial system. When TGA appears in connection with other transient cerebral ischemic attacks, the prognosis is apparently grave with a great risk of a subsequent completed stroke or a permanent memory impairment.

Aged↗

Transient global amnesia -- its clinical and pathophysiological basis and prognosis.

28 patients with transient global amnesia (TGA) were followed for a mean period of 73 months. The patients fell into 3 diagnostic groups: a group where patients had associated symptoms and signs of transient focal cerebral ischemia (TIA), a migraine group and a miscellaneous group. 22 patients had evidence of cerebrovascular disease or risk factors for cerebrovascular disease, and a vascular basis for the amnesic attack was highly suggestive in 25 patients. During the follow-up period 2 patients died, 3 had recurrent TGA and 13 developed a completed stroke or suffered from further TIA's. Permanent memory impairment was encountered in 9 cases. An unfavourable course was related to the presence of other TIA manifestations and/or risk factors for cerebrovascular disease. The study indicates that TGA is probably due to transient ischemia in the vertebrobasilar arterial distribution area. TGA per se has a good prognosis, but the coexistence of risk factor or manifest cerebrovascular disease implies a high rate of a subsequent completed stroke or permanent memory impairment.

Adult↗

Transient global amnesia.

30 patients aged between 45 and 78 years and who had suffered from transient global amnesia (TGA), were seen at the Department of Neurology, Pordenone Public Hospital, in the period 1978 to 1982. 25 patients had one or more risk factors for cerebrovascular disease, such as hypertension, cardiac abnormalities, diabetes and hyperlipidemia. EEG examination revealed abnormal activity only in 7 patients. Brain Computed Tomography showed cerebral atrophy in 10 and hypodense lesions in 3 patients. 16 patients had been followed up for a mean interval of 20 months. During the follow-up period, 4 patients had recurrent TGA and one had a transient ischemic attack in the vertebrobasilar arterial system. In the follow-up group, 15 patients showed permanent memory impairment. The high incidence of risk factors for cerebrovascular disease seems to confirm that TGA is probably due to transient cerebral ischemia. The high rate of permanent memory impairment, almost always connected with the coexistence of cerebrovascular risk factors, is not in agreement with the postulated good prognosis of TGA.

Aged↗

Cranial CT scan in transient global amnesia.

The occurrence of cerebral infarction in patients with transient global amnesia (n = 43) was evaluated by CT scan and compared to that of patients with transient ischemic attacks (TIA) (n = 58) and with no neurological disease (n = 52). Significant differences were demonstrated between TGA and TIA patients in relation to the control group, but no differences were found between patients with TGA and TIA. Our study suggests a vascular mechanism for TGA and that TGA could be considered a low risk TIA in most cases.

Adult↗

Left thalamic hypertensive haemorrhage presenting as transient global amnesia.

A case is described which presented as transient global amnesia (TGA) due to a critically placed intracerebral hypertensive haematoma in the left thalamic region, with epileptic discharges arising from the same area. It is proposed that intracerebral haematomas may occasionally present as a clinically well-defined neurological syndrome. The deficit in such cases is probably not due to the underlying direct tissue damage but secondary to indirect pressure or ischaemic insults.

Amnesia↗

Transient global amnesia and Raynaud's phenomenon in scleroderma.

Transient global amnesia (TGA) is a well-recognized clinical entity, but its pathophysiology and prognosis have remained arguable. We reported that a 63-year-old woman with scleroderma developed two TGA episodes. The patient sometimes suffered from headaches when Raynaud's phenomenon appeared in her fingers, but she did not experience further cerebrovascular events. This case suggests that the unique clinical presentation of this syndrome may result from an ischemic event, possibly triggered by a vasospastic mechanism like Raynaud's phenomenon.

Amnesia↗

Reduction of P3 latency during outcome from post-traumatic amnesia.

We studied 10 patients with post-traumatic amnesia (PTA) and normal CTscans. P3 with an oddball paradigm, several neuropsychological tests and EEG were performed the day after the trauma and several times later until full recovery. In all patients, P3 latencies at admission were above normal limits (mean + 2 SDs) and decreased progressively during recovery from PTA. The latency reductions correlated significantly with improvement of neuropsychological tests.

Adolescent↗

Transient global amnesia: a quantified electroencephalographic study.

In 13 patients who experienced transient global amnesia (TGA), quantified electroencephalographic (qEEG) records were carried out within 1 week of the episodes, and compared with those in 13 cases with cerebral transient ischemic attacks (TIA), and 13 normal controls, matched for age and sex. A statistical comparison of the absolute power showed few differences between TGA and TIA patients, and many statistical differences between TGA patients and controls. The qEEG pattern reveals an involvement of the temporo-parietal structures in TGA patients. These findings suggest the presence of subclinical sequelae, after the TGA attack.

Aged↗

Transient global amnesia and transient ischemic attack: a community-based case-control study.

OBJECTIVES: Few case-control studies of first-ever transient global amnesia (TGA), transient ischemic attack (TIA) and normal controls have been performed to date. We aimed to assess the prevalence of cerebrovascular risk factors in a well defined population of TGA patients. MATERIAL AND METHODS: We undertook a retrospective and prospective community-based case-control study of 170 first-ever TGA, 170 first-ever TIA and 170 normal controls. RESULTS: Age-matched analysis revealed that TGA cases had a significantly lower prevalence of atrial fibrillation and diabetes mellitus than TIA controls. The prevalence of cigarette smoking and diabetes mellitus was significantly higher in normal controls than in TGA cases. CONCLUSION: Our community-based case-control study showed that atrial fibrillation and diabetes mellitus, two important risk factors for cerebrovascular disease, were significantly more common in the TIA group than in the TGA one. These results make the thromboembolic pathogenesis of TGA unlikely.

Amnesia↗

Transient global amnesia -- not always a benign process.

OBJECTIVES: Transient global amnesia (TGA) is an episodic dysfunction of declarative memory, which is assumed to be a benign disorder. Brain perfusion single photon emission computed tomography (SPECT) was shown to be abnormal during the acute stage and to become normal with normalization of memory function. No data are known about the brain perfusion pattern among these patients with recurrent TGA. MATERIAL AND METHODS: Sixteen patients with TGA were studied with an initial brain imaging during the acute stages of their attack, and a second imaging was performed after 3 months. In the event of a patients having a second abnormal brain perfusion HMPAO SPECT, a third imaging was performed after 1 year. RESULTS: Hypofusion perfusion was demonstrated in all cases during the acute stage. In all patients who had a first TGA, a normal SPECT was demonstrated after 3 months. In three patients with recurrent TGA, the brain perfusion remained abnormal after 3 months and after 1 year. CONCLUSIONS: A normal perfusion in TGA after 3 months can be expected in a patient with a first attack. In patients with recurrent TGA attacks, a persistent focal hypoperfusion can be expected. This subgroup of patients may demonstrate a non-benign type of TGA, eventually due to a different etiology of event.

Adult↗

Skin burn, bilateral iridocyclitis and amnesia following a lightning injury.

PURPOSE: To describe a case of lightning injury restricted to the eyes and facial skin. METHODS: Case history describing the clinical examination of a 54-year-old woman. RESULTS: Following a lightning stroke the patient suffered from a sharply demarcated facial skin burn and bilateral iridocyclitis with raised intraocular pressure. Initially she had amnesia regarding the incident. She recovered on symptomatic treatment, with dry eyes as the only sequela. CONCLUSION: We suggest that a lightning current travelled over the outside of the patient's body facilitated by her wet raincoat, a so-called flash-over. Thereby, she was spared from more severe injury, and only the exposed areas of the face and eyes were affected.

Amnesia↗

Enhancement of memory retrieval and attenuation of scopolamine-induced amnesia following administration of 5-HT3 antagonist ICS 205-930.

Experimental evidence suggests an important role of serotonin in the process of learning and memory. The present study investigated the effect of 5HT3-receptor antagonist (ICS 205-930) on retrieval of a previously learned aversive habit in the mouse. The effect of ICS 205-930 on scopolamine (3 mg/kg) induced amnesia was also studied. ICS 205-930 (1, 10 & 100 micrograms/kg) produced a dose-dependent increase in latency to cross into the dark chamber. The scopolamine induced memory impairment was significantly attenuated by ICS 205-930 (10 micrograms/kg). These results suggest that memory deficits may be susceptible to attenuation with non-cholinergic treatments.

Amnesia↗

Transient global amnesia in the district general hospital.

Cases of transient global amnesia (TGA) seen by one consultant neurologist over a 4-year period (2002-2005 inclusive) were identified. Of 10 possible cases, eight fulfilled suggested diagnostic criteria. Five cases were seen as ward consultations, three in outpatient clinics; seven were seen in district general hospitals. Six of the eight cases had already been seen by hospital physicians, whose working diagnoses included stroke/TIA and epilepsy. In some cases, this had resulted in inappropriate investigation, treatment and advice. Although rare, TGA is a diagnosis both hospital physicians and general practitioners need to be aware of in order to avoid potential pitfalls. The critical importance of collateral history in reaching the diagnosis is emphasised.

Aged↗

Memory loss following radiotherapy for nasal pharyngeal carcinoma--an unusual presentation of amnesia.

In this article we describe a patient who developed amnesia several years after receiving a second course of radiotherapy treatment for nasopharyngeal cancer (NPC). Detailed assessment of memory indicated a marked anterograde impairment for verbal material with less impaired non-verbal memory. A dense retrograde deficit was also present, reflected in both poor event memory and loss of general knowledge. Performance on other tests indicated a mild intellectual deficit but no other cognitive impairments. The findings indicate a striking memory disorder arising from late temporal lobe necrosis. These findings stress the importance of assessing neuropsychological sequelae when evaluating the long-term outcome of radiotherapy for NPC and other cancers of the head and neck.

Adult↗