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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Hauptverfasser: Piffer, Silvio (VerfasserIn) , Nannoni, Stefania (VerfasserIn) , Maulucci, Francesco (VerfasserIn) , Beaud, Valérie (VerfasserIn) , Rouaud, Olivier (VerfasserIn) , Förster, Alex (VerfasserIn) , Cereda, Carlo W. (VerfasserIn) , Maeder, Philippe (VerfasserIn) , Michel, Patrik (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 15 October 2022
In: Journal of the neurological sciences
Year: 2022, Jahrgang: 441, Pages: 1-7
ISSN:1878-5883
DOI:10.1016/j.jns.2022.120349
Online-Zugang: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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Verfasserangaben:Silvio Piffer, Stefania Nannoni, Francesco Maulucci, Valérie Beaud, Olivier Rouaud, Alex Förster, Carlo W. Cereda, Philippe Maeder, Patrik Michel

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520 |a 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. 
650 4 |a Amnesia 
650 4 |a Atypical transient global amnesia 
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700 1 |a Michel, Patrik  |e VerfasserIn  |4 aut 
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