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Transient global amnesia vs tia12/10/2023 ![]() ![]() 4īased on my previous work 5 and further study of the literature on TGA the following questions will be discussed in this paper:ġ) Are the Hodges & Warlow 4 diagnostic criteria for TGA specific enough to exclude the risk of missing a mimic such as TEA or ischaemic amnesia?Ģ) In a comprehensive review of non-convulsive status epilepticus (NCSE), Kinney et al stated that TGA can be readily distinguished from NCSE. Box 1 summarises the clinical TGA criteria based on the work of Hodges & Warlow. 2 The chance of re-occurrence is minimal 3 (estimated to be <10% annually), there are no known means of prevention or treatment, and due to its benign nature there is no need for further investigations. 1 “TGA does not increase the long-term risk of cerebrovascular events, seizures, or cognitive impairment”. The whole episode resolves spontaneously leaving only a memory gap of a few hours. They realise that something is wrong with them, become anxious and repeatedly ask the same questions, as they cannot memorise the answer. The neurological examination is unremarkable. Patients, typically between 50 and 80 years of age, are suddenly unable to encode new information, without impairment of attention, self-identity or previously learned skills such as driving or using their phone. We will look at a few arguments that could explain why TGA is possibly an epileptic phenomenon and maybe even a form of non-convulsive status epilepticus.Ĭonsistent with our knowledge of memory formation, transient global amnesia (TGA) is a temporary loss of hippocampal function lasting several hours. But hypothetically TGA might share a common mechanism with its closest mimic, namely transient epileptic amnesia. Its pathophysiology remains elusive, and current hypotheses favour a non-epileptic cause. ![]() These results can be used to counsel patients about risks of recurrence and may have implications for the understanding of TGA pathophysiology.Transient global amnesia (TGA) is a clinically defined syndrome of acute hippocampal dysfunction lasting several hours. This study suggests that, in this large cohort of patients with TGA, recurrent TGA was associated with earlier age at the time of first TGA episode and higher prevalence of both personal and family history of migraine compared with isolated cases. A family history of TGA was identified in 12 individuals (1.3%) with a single episode of TGA and 4 individuals (2.8%) with recurrent episodes of TGA. Acute and subacute temporal lobe abnormalities on results of magnetic resonance imaging were seen rarely and did not require intervention. There were no electroencephalographic findings associated with increased risk of TGA recurrence. 001), and a family history of migraine in 167 individuals (18.5%) with a single episode of TGA and 44 individuals (30.8%) with recurrent episodes of TGA (P =. There was a personal history of migraine in 180 individuals (20.0%) with a single episode of TGA and 52 individuals (36.4%) with recurrent episodes of TGA (P <. The mean (SD) age at first episode of TGA was 65.2 (10.0) years for individuals with a single episode vs 58.8 (10.3) years for those with recurrent episodes (P <. The number of recurrences ranged from 1 to 9, with 137 individuals (95.8%) having 3 or fewer recurrences. The 2 groups were similar in age at inclusion, sex, identifiable triggers, and duration of anterograde amnesia. A total of 901 patients (86.3%) had a single episode of TGA and 143 (13.7%) had recurrent episodes of TGA. Of 1044 included patients, 575 (55.1%) were male, and the mean (SD) age at inclusion was 75.0 (11.5) years. The main outcome measure was TGA recurrence. ![]() A total of 1491 cases were reviewed and 1044 met diagnostic inclusion criteria for TGA, with the remainder excluded owing to indeterminate or alternate diagnoses or limited information available in the medical record.ĭemographics, precipitating factors, migraine history, imaging and electrodiagnostic findings, and family history of TGA were collected. ![]() This retrospective cohort study involved medical record review of patients with isolated or recurrent TGA presenting to the Mayo Clinic in Rochester, Minnesota, between August 1, 1992, and February 28, 2018. To examine risk factors for the recurrence of TGA. However, recurrence rates vary considerably among studies and there are no known risk factors for TGA. Transient global amnesia (TGA) is usually considered a benign event with a low recurrence rate. ![]()
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