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PubMed1989

A case-control study of transient global amnesia.

To evaluate risk factors and prognosis of transient global amnesia (TGA), three groups of 30 subjects each affected respectively by: (1) first-ever TGA; (2) first-ever transient ischaemic attack (TIA); (3) depressive neurosis, were compared. Prevalence of cerebrovascular risk factors was similar in patients with TGA and TIA, but significantly lower in the third group. CT showed more hypodense lesions in TIA patients than in those with TGA. In a mean follow-up of 36 months, five TGA patients experienced a TIA and three others had recurrence of TGA, but none suffered stroke or myocardial infarction. In the TIA group, four had recurrence of TIA, two suffered a stroke and two others a myocardial infarction, whereas none had TGA attacks. None of the patients of the third group had any ischaemic event during follow-up. The similar prevalence of risk factors, but the different prognosis between TGA and TIA patients, suggest that TGA is an ischaemic event, probably not triggered by thromboembolism but by a different, possibly vasospastic, mechanism.

Adult↗
PubMed1994

Primary amnesia of insidious onset with subsequent stabilisation.

A patient had a slowly developing amnesic syndrome that remained substantially unchanged during the two and a half years of observation. Intellectual skills were excellent and there was no language, perception, praxis, or calculation deficit. The memory impairment involved verbal and visual learning, sparing spatial learning and, to a large extent, retrograde memory. Magnetic resonance imaging was normal, but PET showed a hypometabolism of the left temporal mesial region and thalamus. This case extends the spectrum of monosymptomatic cognitive disorders, previously reported in the area of language, praxis, and visual recognition, to amnesia.

Aged↗
PubMed1994

Post-traumatic amnesia: still a valuable yardstick.

Records of coma and post-traumatic amnesia (PTA) were collected for a group of 38 patients with closed head injury. The results confirmed earlier studies indicating that patients may have short or negligible coma but report prolonged PTA. Comparison of eight patients with prolonged PTA (> 7 days) and short coma (< 6 hours) with the rest of the group on MRI in the acute stage showed that these patients had significantly more extensive hemispheric damage. In the group as a whole both coma and PTA were related to the number of areas in central brain structures in which lesions were detected, but only PTA was significantly related to the number of hemispheric areas in which lesions were found. It is concluded that although both coma and PTA are related to brain damage they reflect disparate patterns of lesions. Assessment of PTA can thus provide additional information concerning severity of injury.

Adolescent↗
PubMed1994

Semantic memory and frontal executive function during transient global amnesia.

To assess semantic memory and frontal executive function, two patients underwent neuropsychological testing during transient global amnesia (TGA) and after an interval of 6-8 weeks. In spite of a profound deficit in anterograde verbal and non-verbal memory, semantic memory was normal, as judged by category fluency measures, picture naming, and picture-word and picture-picture matching, and reading ability was normal. Similarly, there were no deficits on a number of tests known to be sensitive to frontal executive dysfunction. A hexamethylpropyleneamine-oxime (HMPAO) single photon emission CT (SPECT) scan, obtained on one patient 24 hours post-TGA, showed focal left temporal lobe hypoperfusion which had resolved three months later. The observed dissociation between episodic and semantic memory is discussed in the light of contemporary cognitive theories of memory organisation.

Aged↗
PubMed1994

Are brief or recurrent transient global amnesias of epileptic origin?

To evaluate if short (less than one hour) or recurrent, or both, episodes of transient global amnesia (TGA) have an epileptic origin or carry a subsequent risk of epilepsy a group of patients with these types of TGA attacks was studied. The group was selected from a prospective series of 103 patients with TGA. Sixteen patients had an episode lasting less than one hour, 13 had more than one episode, and five patients had both short and recurrent attacks. For each patient the number of recurrences was small (four or less) and they were separated by months or years. During short attacks of TGA many subjects showed other typical features of TGA including repeated questioning (12 subjects) and performance of purposeful complex acts (eight subjects). Twelve short attacks were closely related to a characteristic precipitating event. During follow up only one patient had a seizure (partial motor). No other association between either short or repeated attacks of TGA and past history of epilepsy or paroxysmal discharges were seen on the EEG. Short or recurrent, or both, attacks of TGA are not epileptic and do not carry a relevant risk of subsequent seizures.

Aged↗
PubMed2001

Structural MRI volumetric analysis in patients with organic amnesia, 1: methods and comparative findings across diagnostic groups.

BACKGROUND: If they are to be replicable, MRI volume measurements require explicit definitions of structures and of criteria for delineating these structures on MRI. Previously published volumes in healthy subjects show considerable differences in measurements across different studies, including a fourfold variation in estimates of hippocampal volume. Previous neuroimaging reports in patients with Korsakoff syndrome have generally found widespread or non-specific change, whereas in patients with herpes encephalitis the extent of pathological involvement reported beyond the temporal lobes has varied. METHOD: In the present study, a clear set of anatomical criteria and detailed MRI segmentation procedures were applied to measure whole brain, frontal and temporal lobe, and anterolateral and medial temporal volumes, as well as thalamic areas in patients with organic amnesia (from Korsakoff's syndrome, herpes encephalitis, and focal frontal lesions) as well as healthy controls. RESULTS: Patients with Korsakoff's syndrome showed decreased thalamic measurements but no significant changes in the medial temporal lobes, whereas patients with herpes encephalitis showed severe medial temporal but not thalamic atrophy. In the patients with known frontal lobe lesions, quantitative analysis on MRI showed reduced frontal lobe volume but no significant temporal lobe or thalamic atrophy. CONCLUSION: Quantified MRI can be a useful technique with which to examine brain-cognitive relations, provided that detailed techniques are explicitly described. In particular, specific patterns of volume change can be found in vivo in patients with Korsakoff's syndrome and those with herpes encephalitis.

Adult↗
PubMed2001

Structural MRI volumetric analysis in patients with organic amnesia, 2: correlations with anterograde memory and executive tests in 40 patients.

BACKGROUND: Cognitive-MRI correlations have often been studied in disorders in which there are multiple cognitive deficits and widespread cortical atrophy, such as Alzheimer's dementia. In such circumstances, the interpretation of any single cognitive-structural correlation is equivocal. Only by measuring differing cognitive functions and a wide range of brain structures in patients with a varying distribution of lesions or atrophy can specific brain-cognitive relations be determined in neurological disorder. METHOD: In the present study, a clear set of anatomical criteria and detailed MRI segmentation procedures were applied to measure whole brain, and left and right frontal, temporal lobe, anterolateral and medial temporal volumes, as well as thalamic cross sectional areas in 40 patients with organic amnesia (from various diseases) and 10 healthy controls. RESULTS: Within the total patient group, anterograde memory measures correlated significantly with medial temporal, hippocampal, and thalamic measurements. A spatial memory measure correlated significantly with hippocampal volume, and temporal context memory with frontal volume. After a factor analysis of the cognitive measures, the association between anterograde memory and hippocampal volume was corroborated. Forgetting rates and subjective memory evaluations did not show any significant MR correlations and, of executive tests employed, only card sorting categories correlated significantly with frontal volume. CONCLUSION: Loss of volume in key brain structures (for example, hippocampus, thalamus) is detectable on quantitative MRI, and this loss of volume correlates significantly with impaired performance on measures of anterograde memory function. Correlations with hippocampal volume did not indicate a specific role in either recall or verbal memory, as opposed to recognition or visual memory.

Alcohol Amnestic Disorder↗
PubMed1989

Syndrome of downward gaze paralysis, amnesia and hypersomnolence.

A 60 year old woman with computed tomographic-verified bilateral thalamic infarction is described. She demonstrated downward gaze paralysis, amnesia and hypersomnolence. On the functional level such tasks as walking and eating were disconcerting. Although there have been only a few reports of the complete triad it may be more common than realized and represents a distinct syndrome that can be identified by the bedside.

Amnesia↗
PubMed2003

The ameliorating effects of cognition-enhancing Chinese herbs on scopolamine- and MK-801-induced amnesia in rats.

The study was to investigate the ameliorating effects of three Chinese herbs--Achyranthes bidentata (AB), Ophiopogon japonicus (OJ) and Cnidium monnieri (CM) on scopolamine (SCOP)- and MK-801-induced amnesia by using a passive avoidance task in rats. AB, OJ and CM at 0.1 and 0.3 g/kg prolonged the step-through latency (STL) of the retention trial. In addition, AB, OJ and CM reversed the STL shortened by MK-801, but only AB reversed the STL shortened by SCOP. In conclusion, these Chinese herbs possess cognition-enhancing activities and anti-amnestic effects, but the mechanism of the effect of AB was different from those of OJ and CM.

Achyranthes↗
PubMed2005

[Recurrent Transient Global Amnesia, a manifestation of ischemic cerebrovascular disease].

BACKGROUND AND OBJECTIVE: Transient Global Amnesia (TGA) is a self-limited anterograde memory loss related classically to transient ischemic attacks (TIA), migraine and epilepsy. This study intended to describe clinical characteristics, the vascular risk factors and the evolution of TGA and to define clinical factors associated with recurrence. PATIENTS AND METHOD: Of 139 patients with TGA, 124 were followed up for a mean time of 71.9 (39) months; these patients were compared with other 124 patients with TIA. The TGA group was subdivided in 2 subgroups: Unique-TGA (98 cases): 1 episode, and recurrent-TGA (26 cases): 2 or more episodes. Recurrent-TGA were also compared with unique-TGA and the TIA groups. RESULTS: The mean age of patients of the TGA group was 63 (7.96) and 58% were women. 30% had a history of migraine and 30% had anxiety. The risk of annual recurrence was 4.4%. Recurrent-TGA patients had more electroencephalographic registers showing non-epileptogenic abnormalities. The TIA group had more vascular risk factors and displayed more ischemic events during the follow-up. Recurrent-TGA patients had the same vascular risk factors as TIA patients and they also had a significantly more frequent history of stroke and trend to suffer new ischemic events than patients in the unique-TGA group. CONCLUSIONS: There is no vascular pathology substrate in TGA patients, suggesting an ischemic etiology due to arteriosclerosis or cardioembolism. Patients with recurrent TGA constitute a subgroup with more vascular risk factors and an increased risk to suffer new strokes. For that reason we propose that these patients be studied as ischemic patients.

Amnesia, Transient Global↗
PubMed1998

Transient global amnesia and migraine. A case control study.

This study examined the putative association of transient global amnesia (TGA) and migraine. 57 TGA patients were compared to a double-size control group of normal subjects. TGA patients who also had migraine were additionally compared to those without migraine and to a second control group of outpatients with migraine only. The prevalence of migraine, and also of episodic tension-type headache, was markedly increased among TGA patients. Precipitants and accompanying vegetative symptoms of TGA and migraine overlapped. However, there was no evidence of an interaction between TGA and migraine, in that the expression of key TGA features was not affected by comorbidity with migraine, and vice versa. The present findings argue against the hypothesis that TGA represents a type of migraine aura or migraine equivalent. They conform to the hypothesis that the two conditions are essentially independent and result from an inherited brain state that disposes to different types of paroxysmal dysregulation, presumably at the level of the brain stem.

Amnesia↗
PubMed2003

Transient global amnesia: a clinical and sonographic study.

BACKGROUND: The aetiology of transient global amnesia (TGA) is still unknown. The aim of this study was to identify potential risk factors for TGA, vascular risk factors, the role of patent foramen ovale (PFO) and of retrograde jugular venous flow. METHODS: 138 subjects entered the study, including 48 patients with TGA, 42 age-matched patients with transient ischaemic attack (TIA) and 48 controls. PFO was studied by contrast transcranial duplex sonography. Retrograde jugular venous flow was tested with air contrast ultrasound venography (ACUV). RESULTS: TGA patients and controls showed a lower prevalence for vascular risk factors than TIA patients. No statistical difference was found between the 3 groups with regard to PFO. ACUV detected jugular valve incompetence in 72.9% TGA, 35.7% TIA and 39.5% controls (TGA vs. TIA and TGA vs. controls p < 0.01). CONCLUSIONS: TGA patients have fewer vascular risk factors than TIA patients. Paradoxical embolism due to PFO as a cause of TGA is not confirmed in our study. Cerebral venous hypertension due to incompetence of the internal jugular valve may play a role in the pathogenesis of TGA.

Amnesia, Transient Global↗
PubMedDate not supplied

Isolated amnesia with slow onset and stable course, without ensuing dementia: MRI and PET data and a six-year neuropsychological follow-up.

Patient EDS presented with an amnesic disorder of insidious onset (4 years) that remained stable and restricted to memory functions over a 10-year course. Repeated neuropsychological evaluations over 6 years showed a moderate-to-severe, stable impairment of long-term memory and of memory for public events, and a milder, stable impairment of autobiographic memory and of short-term memory. Language, perception, praxis and 'frontal' functions were fully preserved. MRI showed atrophy of the right hippocampus, of the right mammillary body and of the sylvian fissure (bilaterally, but more marked on the left). On PET scan, metabolic activity in the mesial temporal structures was significantly reduced on the right and was at lower normal levels on the left. The disorder observed in EDS is similar to that recently reported in other patients. Possible etiologies of the selective amnesia observed in EDS are considered and their implications discussed.

Age of Onset↗
PubMed1980

Posttraumatic amnesia, post-concussional symptoms and accident neurosis.

This communication surveys 398 consecutive head injury patients who were in regular full-time employment at the time of injury and who were examined in connection with a claim for compensation. In uncomplicated cases there was a close correlation between the duration of posttraumatic amnesia and the length of time off work. Some common causes of prolonged organic disability are mentioned. The recovery rate of patients suffering from posttraumatic emotional disorders, such as depression or anxiety, was proportional to the initial severity of injury, whereas the indefinite invalidism associated with so-called 'accident neurosis' was found to be rare in severely injured patients. 'Accident neurosis' also was more common in manual workers sustaining accidents at work than in the same occupation group after road accidents, or in non-manual workers. It is concluded that posttraumatic emotional disorder and 'accident neurosis' are not the extremes of a spectrum but separate and distinguishable conditions.

Accidents↗
PubMedDate not supplied

Computer tomography in transient global amnesia.

16 patients with transient global amnesia (TGA) have been investigated by computer tomography. 3 had a completed stroke associated with the TGA. The findings of computer tomography were normal in 7 patients. Atrophy alone was seen in 2 patients. A single hypodense lesion was found in 6 patients; a bilateral lesion in 1 patient. All 3 patients with amnesic stroke showed a hypodense lesion in the CT.

Adult↗
PubMed1986

'Indifférence amnésique' in a case of global amnesia following acute brain hypoxia.

A patient is described who, following an episode of acute brain hypoxia, showed the selective neuropsychological syndrome of Global Amnesia, including preserved unconscious procedural learning ability, associated with the clinical feature of 'indifférence amnésique'. A 12-month follow-up neuropsychological study failed to show any evolution of the memory and emotional disorders, as in other amnesics with eventual widespread brain damage.

Acute Disease↗
PubMed1988

Transient global amnesia: pathogenesis and prognosis.

Fifty-five patients admitted to hospital for 'pure' transient global amnesia (TGA) were studied and followed up for a period ranging from 12 to 67 months. The major pathogenetic theories of TGA (epileptic, thrombotic and migrainous) were investigated through the study of clinical histories and risk factors and the recurrences of neurological disturbances during follow-up. Seventy-one percent of the sample had one or more thrombotic risk factors (TRF), 2 patients had both TRF and a history of migraine, and none ever experienced a seizure. A computerized tomography (CT) scan was performed in 40 out of 55 patients to detect focal lesions: 3 patients (7.5%) had a lacuna in the deep structures of the brain. Over the follow-up period, 1 patient died from hepatic cirrhosis, 1 patient died from cerebral haemorrhage, 2 patients experienced transient ischaemic attacks and 3 patients had a total of 4 TGA recurrences. Our conclusion is that TGA represents a benign form of transient ischaemic cerebral disease.

Adult↗
PubMed1992

Prognosis of transient global amnesia: a long-term follow-up study.

A long-term follow-up study was performed on patients with transient global amnesia (TGA) in order to evaluate the prognosis, the recurrence rate and the occurrence of stroke and dementia. 102 patients (57 women, 45 men; mean age 62.8 +/- 9.4 years) were prospectively included and followed up. The follow-up duration ranged between 12 and 241 months with an average value of 82.2 +/- 51.1 (mean +/- SD). The death rate showed no difference from that of sex- and age-matched subjects. TGA recurred in 19 cases (18.63%). Only 4 patients suffered subsequent stroke, and only 3 showed intellectual deterioration. TGA prognosis was shown to be better than that of RIA and lacunar patients.

Adult↗