Studies with a mean duration of follow-up of at least 3 years have found recurrence rates ranging from 2.9% to 23.8%. Transient global amnesia is usually an isolated event, with variable recurrence rates reported in the literature. 8, 9 Results of magnetic resonance imaging (MRI) may show a small focus of restricted diffusion initially, particularly in the hippocampus. Electroencephalography findings are generally nonspecific, but rare epileptiform discharges may be present in those with concomitant epilepsy. Quiz Ref ID Results of diagnostic workup, including electroencephalography (EEG) and brain and vessel imaging, are typically normal during and after a TGA episode. Likewise, most individuals who experience migraine never have an episode of TGA. Although there is a strong familial predisposition for migraine, there are only rare case reports of familial clusters of TGA. 5 - 7 However, the exact association between TGA and migraine remains unclear. 1 There is also a strong association of TGA with migraine, suggesting a potential shared genetic or pathophysiological mechanism. 4 These triggers support the prevailing notion that TGA may be caused by transient intracranial venous hypertension. 1 - 3Įpisodes of TGA often have an identifiable trigger, such as the Valsalva maneuver, sexual intercourse, exercise, or strong emotion. The inability to form new memories during an episode of TGA often causes patients to ask questions repetitively, while their identity, consciousness, and other neurologic functions remain intact. Quiz Ref ID Transient global amnesia (TGA) is a clinical syndrome characterized by sudden-onset anterograde amnesia that typically lasts 4 to 6 hours but can last up to 24 hours. These results can be used to counsel patients about risks of recurrence and may have implications for the understanding of TGA pathophysiology. 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.Ĭonclusions and Relevance 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. 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. 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 < .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 = .001). 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 < .001). 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. Results 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. Main Outcomes and Measures Demographics, precipitating factors, migraine history, imaging and electrodiagnostic findings, and family history of TGA were collected. 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.Įxposures Single vs recurrent episodes of TGA. Objective To examine risk factors for the recurrence of TGA.ĭesign, Setting, and Participants 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. However, recurrence rates vary considerably among studies and there are no known risk factors for TGA. Importance Transient global amnesia (TGA) is usually considered a benign event with a low recurrence rate. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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