Transient global amnesia with unexpected clinical and radiological findings: a case series and systematic review
Background - Transient global amnesia (TGA) represents a benign neurological syndrome of unknown pathophysiology, often accompanied by vanishing hippocampal punctate diffusion-weighted imaging lesions (HPDL). The literature suggests that TGA may present with unusual features. This study analyses aty...
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| Main Authors: | , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
15 October 2022
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| In: |
Journal of the neurological sciences
Year: 2022, Volume: 441, Pages: 1-7 |
| ISSN: | 1878-5883 |
| DOI: | 10.1016/j.jns.2022.120349 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jns.2022.120349 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0022510X22002118 
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| Author Notes: | Silvio Piffer, Stefania Nannoni, Francesco Maulucci, Valérie Beaud, Olivier Rouaud, Alex Förster, Carlo W. Cereda, Philippe Maeder, Patrik Michel |
| Summary: | Background - Transient global amnesia (TGA) represents a benign neurological syndrome of unknown pathophysiology, often accompanied by vanishing hippocampal punctate diffusion-weighted imaging lesions (HPDL). The literature suggests that TGA may present with unusual features. This study analyses atypical clinical and radiological manifestations of patients with TGA and/or HPDL. - Methods - We retrospectively reviewed patients with atypical clinical or radiological presentations of TGA and/or HPDL in three neurology centers. We also performed a systematic review of literature using predefined search terms. Results were classified as: A) Atypical clinical manifestations of TGA (such as amnesia with additional manifestations, or only non-amnesic manifestations); B) Atypical radiological manifestations of clinically typical TGA. - Results - We identified 83 patients: 18 in our centres (median age 63.5years, 39% female) and 65 in the literature. In group A, 43 patients presented atypical clinical manifestations such as TGA with added transitory cognitive or sensory-motor deficits, seizures, headaches, but also non-amnesic presentations associated with HPDL and incidental HPDL without symptoms. In group B, 40 patients with typical clinical TGA showed extra-hippocampal punctate diffusion lesions (E-HPDL) which disappeared on follow-up imaging. Using clinical and radiological manifestations, we classified these patients into different categories describing a “TGA-PDL spectrum”. - Conclusions - TGA may have atypical clinical manifestations despite typical neuroimaging and patients with typical TGA may show vanishing extra-hippocampal punctate diffusion lesions. TGA, related clinical manifestations, and vanishing punctate diffusion lesions should be considered part of a larger “TGA-PDL spectrum”, allowing for better diagnosis of typical and atypical cases and stimulating further studies. |
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| Item Description: | Online verfügbar: 23 July 2022, Artikelversion: 6 August 2022 Gesehen am 22.08.2023 |
| Physical Description: | Online Resource |
| ISSN: | 1878-5883 |
| DOI: | 10.1016/j.jns.2022.120349 |