Event related potentials in patients with transient global amnesia—A prospective controlled study

Buhr, J.; Evers, Stefan; Husstedt, Ingo W.; Frese, A.

doi:10.1016/j.jns.2012.11.017

Cited by 3 publications

(6 citation statements)

References 39 publications

(68 reference statements)

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“…In general, the prognosis of a TGA is very favorable: Although the acute amnesia usually disappears within 24 h, some patients sometimes still feel subjectively impaired and irritated for several days after the attack. Populationbased studies and meta-analyses also showed complete regression of symptoms over the long-term course [58][59][60][61].…”

Section: Prognosismentioning

confidence: 86%

Guideline “Transient Global Amnesia (TGA)” of the German Society of Neurology (Deutsche Gesellschaft für Neurologie): S1-guideline

Sander¹,

Bartsch²,

Connolly³

et al. 2023

Neurol. Res. Pract.

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Introduction In 2022 the DGN (Deutsche Gesellschaft für Neurologie) published an updated Transient Global Amnesia (TGA) guideline. TGA is characterized by a sudden onset of retrograde and anterograde amnesia for a period of one to a maximum of 24 h (with an average of 6 to 8 h). The incidence is estimated between 3 and 8 per 100,000 population/year. TGA is a disorder that occurs predominantly between 50 and 70 years. Recommendations The diagnosis of TGA should be made clinically. In case of an atypical clinical presentation or suspicion of a possible differential diagnosis, further diagnostics should be performed immediately. The detection of typical unilateral or bilateral punctate DWI/T2 lesions in the hippocampus (especially the CA1 region) in a proportion of patients proves TGA. The sensitivity of MRI is considered higher when performed between 24 and 72 h after onset. If additional DWI changes occur outside the hippocampus, a vascular etiology should be considered, and prompt sonographic and cardiac diagnostics should be performed EEG may help to differentiate TGA from rare amnestic epileptic attacks, especially in recurrent amnestic attacks. TGA in patients < 50 years of age is a rarity, therefore it is mandatory to rapidly search for other causes in particular in younger patients. The cause of TGA is still unknown. Numerous findings in recent years point to a multifactorial genesis. Because the pathomechanism of TGA is not yet clearly known, no evidence-based therapeutic or prophylactic recommendations can be made. Conclusions There is no evidence for chronic sequelae of TGA with respect to cerebral ischemia, chronic memory impairment, or the onset of dementia-related syndromes.

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Section: Prognosismentioning

confidence: 86%

Guideline “Transient Global Amnesia (TGA)” of the German Society of Neurology (Deutsche Gesellschaft für Neurologie): S1-guideline

Sander¹,

Bartsch²,

Connolly³

et al. 2023

Neurol. Res. Pract.

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“…A total of 1,658 studies were identified from databases. 36 4-11,14-16,18-40,e1,e2 studies were selected covering 4,514 TGA cases and 544 recurrence events. The mean age was 62.67 years, CI 95% (61.78–63.56), and tau 2 = 4.719, and the female's proportion was 59.34%, CI 95% (51.30%–66.90% 0.1948), and tau 2 = 0.1948.…”

Section: Resultsmentioning

confidence: 99%

“…The mean age was 62.67 years, CI 95% (61.78–63.56), and tau 2 = 4.719, and the female's proportion was 59.34%, CI 95% (51.30%–66.90% 0.1948), and tau 2 = 0.1948. Regarding study design, 14 were case-control 9-11,14,16,19,27,28,30,33,35-37,40 and 22, cohort studies. 4-8,15,18,20-26,29,31,32,34,38,39,e1,e2 Table 1 summarizes the descriptive features of the studies.…”

Section: Resultsmentioning

confidence: 99%

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Transient Global Amnesia Recurrence

et al. 2022

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Background:Transient global amnesia (TGA) is an acute amnestic disorder with unclear pathophysiology. Although considered a benign phenomenon, the possibility of a recurrence is a major concern for the patient. Our objective is to identify the prevalence and risk factors of relapse, to help clinicians counsel patients about it.Methods:According to PRISMA guidance, we screened 1658 studies from MEDLINE, Lilacs and Embase databases, published from 1985 to April 2021, in English or Spanish. We included 36 observational case-control and cohort studies that included patients with TGA according to Caplan’s or Hodges and Warlow’s diagnostic criteria. We performed a meta-analysis with a random effect model for proportions and calculation of odds ratio for identified risk factors. Methodological quality was assessed according to the Newcastle-Ottawa Scale.Results:We identified 4514 TGA and 544 recurrence events (12.73%). Follow-up had no impact on its variance. We identified a statistically significant association between recurrence and sexual activity as a trigger, past or present personal history of migraine and depression (OR 1,481 95%CI [1,0341; 2,1222] p=0,04; OR=2,0795 IC95% [1,3892; 3,1128] p=0,003; and OR=4,487195%CI [1,890; 10,651] p=0,0288, respectively).Conclusions:The analysis showed that about 1 out of 8 subjects may have recurrence, with an increased risk in case of past or present history of migraine, depression or sexual intercourse prior to the event. Personal history of migraine and depression are associated with two and four times risk, respectively.

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“…Interestingly, TGA-patients with and without DWI lesions do not differ in clinical symptoms and cognitive functions in the long term ( 12 ). Although, no permanent lesions could be shown by MRI ( 8 , 12 ), electrophysiological abnormalities in event-related potentials could prove prolonged effects even after 17 months ( 13 ). These observations may suggest permanent functional damage within the hippocampal structures and its neuronal networks, although, confirmation of this long-term memory impairment has not yet been published.…”

Section: Introductionmentioning

confidence: 99%

Transient Global Amnesia (TGA): Influence of Acute Hypertension in Patients Not Adapted to Chronic Hypertension

et al. 2021

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Objective: Transient global amnesia (TGA) is defined by an acute memory disturbance of unclear etiology for a period of <24 h. Several studies showed differences in vascular risk factors between TGA compared to transient ischemic attack (TIA) or healthy controls with varying results. This retrospective and cross-sectional study compares the cardiovascular risk profile of TGA patients with that of acute stroke patients.Methods: Cardiovascular risk profile and MR imaging of 277 TGA patients was retrospectively analyzed and compared to 216 acute ischemic stroke patients (26% TIA).Results: TGA patients were significantly younger and predominantly female compared to stroke patients. A total of 90.6% of TGA patients underwent MRI, and 53% of those showed hippocampal diffusion-weighted imaging (DWI) lesions. Scores for cerebral microangiopathy were lower in TGA patients compared to stroke patients. After statistical correction for age, TGA patients had higher systolic and diastolic blood pressure, higher cholesterol levels, lower HbA1c, as well as blood glucose levels, and lower CHA2DS2-VASc scores. Stroke patients initially displayed higher CRP levels than TIA and TGA patients. TGA patients without DWI lesions were older and showed higher CHA2DS2-VASc scores compared to TGA patients with DWI lesions.Conclusion: This study revealed significant differences between TGA and stroke patients in regard to the cardiovascular risk profile. Our main findings show a strong association between acute hypertensive peaks and TGA in patients not adapted to chronic hypertension, indicating a vascular cause of the disease.

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Event related potentials in patients with transient global amnesia—A prospective controlled study

Cited by 3 publications

References 39 publications

Guideline “Transient Global Amnesia (TGA)” of the German Society of Neurology (Deutsche Gesellschaft für Neurologie): S1-guideline

Guideline “Transient Global Amnesia (TGA)” of the German Society of Neurology (Deutsche Gesellschaft für Neurologie): S1-guideline

Transient Global Amnesia Recurrence

Transient Global Amnesia (TGA): Influence of Acute Hypertension in Patients Not Adapted to Chronic Hypertension

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