FDG-PET identified focal hypometabolism in 2/8 cases where it was performed, both involving the frontal and/or temporal regions. Brain MRI revealed focal abnormalities in only 4/19 cases (21%). In numerous cases, sleep and prolonged EEG evaluations identified abnormalities not previously seen on shorter or awake-state studies. EEG revealed epileptiform abnormalities involving the frontal and/or temporal regions in 12/19 individuals (63%), including activation during sleep in all of these cases. Thirteen patients (68%) reported persistent cognitive/behavioral symptoms, including 4 (21%) for whom these were the chief presenting complaints. Results: Nineteen patients were identified (14 men, 5 women) with median onset age 66 years and median time to diagnosis 2 years. Diagnostic criteria included the presence of recurrent episodes of transient amnesia with preservation of other cognitive functions and evidence for epilepsy. Methods: We performed a retrospective analysis of patients diagnosed with TEA at the Mayo Clinic Minnesota from Januto September 21, 2017. All rights reserved.Objective: To characterize the clinical, EEG, and neuroimaging profiles of transient epileptic amnesia (TEA). However, simple clinical data and widely available neurophysiological examinations can truly help to effectively distinguish TEA from TGA.Įpileptic amnesia Focal seizure Temporal lobe epilepsy Transient amnesia Transient global amnesia.Ĭopyright © 2018 Elsevier Inc. Our findings show that in a real-life clinical scenario, TEA is frequent but often overlooked. In the group with TGA, the only imaging alteration found was diffusion weighted imaging (DWI) hippocampal hyperintensity. Finally, structural abnormalities were more frequent in patients with TEA (26.6%). On the contrary, 24-h EEG showed IEAs in all patients with epilepsy, mostly during sleep, suggesting an essential diagnostic role of long-lasting EEG recording for TEA. The analysis of st-EEG results evidenced low sensitivity for interictal epileptiform abnormalities (IEAs) detection (52.3%), with not conclusive data in distinguishing TEA from TGA. This result could be related with a prolonged postictal state in these patients. In our sample, duration of the episodes did not significantly differ between TGA and TEA, even though it is usually described as shorter for TEA.
#Transient epileptic amnesia plus#
001) and atypical symptoms such as confusion or language disorder (TGA plus manifestations), appear to be key elements in order to discriminate between TEA and TGA (80% of patients with TEA vs 7.8% of patients with TGA p <. From a clinical point of view recurrence (p <. Clinical features, neurophysiological, and neuroimaging data were analyzed and compared in the two groups (TEA and TGA).ĭiagnosis of TEA, according to Zeman's criteria, was made in 15 patients (18%). Moreover, patients with borderline epileptiform abnormalities on st-EEG or with normal st-EEG but high clinical suspicion for TEA underwent a 16-channel 24-hour ambulatory EEG (24-h EEG). All patients underwent neurological evaluation, magnetic resonance imaging (MRI) scan, and standard 21-channel scalp electroencephalography (EEG) recording (standard EEG ). We retrospectively collected clinical data of 83 patients who accessed our emergency ward for an abrupt onset of amnesic disorder, initially interpreted as TGA. We designed this study to evaluate the actual frequency of TEA in a real-life scenario and to highlight the features that can help clinicians distinguishing it from TGA. Transient epileptic amnesia (TEA) is an underestimated condition in emergency clinical setting, where most of transient amnesic episodes tend to be classified as transient global amnesia (TGA).
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