Transient Global Amenesia ========================= þ TGA Epidemiology and Natural Course - SUMMARY: "Transient global amnesia (TGA) has been defined as the presence of an impairment of short-term memory, retrograde amnesia and repetitive queries, without any other neurological signs or symptoms. The precise pathophysiology of TGA is unclear, although thromboembolic, epileptic, migrainous and metabolic mechanisms have been suggested." [Moccia F, Aramini A, Montobbio P, Altomonte F, Greco G. Transient global amnesia: disease or syndrome? Ital J Neurol Sci 1996; 17:211-4.] - ACUTE CONFUSIONAL MIGRAINE in children shares many similarities with TGA in adults: [Sheth RD, Riggs JE, Bodensteiner JB. Acute confusional migraine: variant of transient global amnesia. Pediatr Neurol 1995; 12:129-31.] Abstract: - INCIDENCE is probably 5-6/100,000 population/year [Lauria G, Gentile M, Fassetta G, Casetta I, Caneve G. Incidence of transient global amnesia in the Belluno province, Italy: 1985 through 1995. Results of a community-based study. Acta Neurol Scand 1997; 95:303-10.] Abstract: - RECOVERY + may occur in about an hour in some cases (about 15%): [Melo TP, Ferro JM, Paiva T. Are brief or recurrent transient global amnesias of epileptic origin?J Neurol Neurosurg Psychiatry 1994; 57:622-5.] Abstract: + at least in this case took a week, with some residual deficits for 4 weeks: [Okura M, Tomotake M, Mori K, Ikuta T. Recovery of high speed memory scanning after transient global amnesia: a case report. Psychiatry Clin Neurosci 1996; 50:317-21.] + but another study shows an average extent of seven hours: [Moreno-Lugris XC, Martinez-Alvarez J, Branas F, Martinez-Vazquez F, Cortes-Laino JA. [Transient global amnesia. Case-control study of 24 cases] Rev Neurol 1996; 24:554-7.] - RECURRENCE was found in about 10% of cases in this study: [Melo TP, Ferro JM, Paiva T. Are brief or recurrent transient global amnesias of epileptic origin? J Neurol Neurosurg Psychiatry 1994; 57:622-5.] Abstract: þ TGA Causes: - MIGRAINE: + some association with presumed migraine in young people in competitive sports: [Tosi L, Righetti CA. Transient global amnesia and migraine in young people. Clin Neurol Neurosurg 1997; 99:63-5.] Abstract: + only one of a constellation of non-headache migranous syndromes: [Buchholz DW, Reich SG. The menagerie of migraine. Semin Neurol 1996; 16:83-93.] Abstract: - CVA or TIA: [Chen WH, Liu JS, Wu SC, Chang YY. Transient global amnesia and thalamic hemorrhage. Clin Neurol Neurosurg 1996; 98:309-11.] Abstract: [Raffaele R, Tornali C, Genazzani AA, Vecchio I, Rampello L. Transient global amnesia and cerebral infarct: a case report. Brain Inj 1995; 9:815-8.] Abstract: but there is one study that argues that migraine, and to a lesser extent seizure, are much more common than TIA as the cause of TGA: [Zorzon M, Antonutti L, Mase G, et al. Transient global amnesia and transient ischemic attack. Natural history, vascular risk factors, and associated conditions Stroke 1995; 26:1536-42.] Abstract: - SEIZURES: [Meo R, Bilo L, Striano S, et al. Transient global amnesia of epileptic origin accompanied by fever. Seizure 1995; 4:311-7.] Abstract: but this prospective study showed really no association with seizures: [Melo TP, Ferro JM, Paiva T. Are brief or recurrent transient global amnesias of epileptic origin? J Neurol Neurosurg Psychiatry 1994; 57:622-5.] Abstract: - STRESS: some association with stress (? if migraine precipitant) [Inzitari D, Pantoni L, Lamassa M, et al. Emotional arousal and phobia in transient global amnesia. Arch Neurol 1997; 54:866-73.] Abstract: - SUBCLAVIAN STEAL: may be associated with exercise/subclavian steal [Cone AM. Exercise-induced transient global amnesia in a patient with subclavian steal. Anaesth Intensive Care 1994; 22:95-6.] Abstract: [Blasco MR, Arjona A, Jimenez C, Escamilla C. Global transient amnesia and subclavian steal syndrome [letter]. Lancet 1996; 347:1636.] - HEAVY LIFTING + PATENT FORAMEN OVALE with presumptive paradoxical embolism: [Klotzsch C, Sliwka U, Berlit P, Noth J. An increased frequency of patent foramen ovale in patients with transient global amnesia. Analysis of 53 consecutive patients. Arch Neurol 1996; 53:504-8.] Abstract: - DRUGS: some association with certain drugs: + oral contraceptives [Orefice G, Soriente L, Cerbone AM, et al. Transient global amnesia in a young woman on prolonged treatment with oral contraceptive drugs [letter] Thromb Haemost 1996; 75:980.] + propafenone [Jones RJ, Brace SR, Vander Tuin EL. Probable propafenone-induced transient global amnesia. Ann Pharmacother 1995; 29:586-90.] Abstract: + heparin? [Warkentin TE, Hirte HW, Anderson DR, et al. Transient global amnesia associated with acute heparin-induced thrombocytopenia. Am J Med 1994; 97:489-91.] - ANGIOGRAMS: TGA can be cause by angiograms, presumably due to vasospasm: [Meder JF, Mourey-Gerosa I, Blustajn J, et al. Transient global amnesia after cerebral angiography. A case report. Acta Radiol 1997; 38:273-4.] Abstract: [Jackson A, Stewart G, Wood A, Gillespie JE. Transient global amnesia and cortical blindness after vertebral angiography: further evidence for the role of arterial spasm AJNR Am J Neuroradiol 1995; 16:955-9.] Abstract: [Schamschula RG, Soo MY. Transient global amnesia following cerebral angiography with non-ionic contrast medium. Australas Radiol 1994; 38:196-8.] Abstract: - EARLY SIGN OF ENCEPHALITIS: [Kimura S, Kumano T, Miyao S, Teramoto J. Herpes simplex encephalitis with transient global amnesia as an early sign. Intern Med 1995; 34:131-3.] Abstract: - AV FISTULA IN BRAIN: [Takahashi Y, Yamamoto T, Abe T, et al. Transient global amnesia and dural arteriovenous fistula of the anterior cranial fossa. Kurume Med J 1996; 43:223-9.] - BRAIN THROMBOPHLEBITIS: [Attarian S, Michel B, Delaforte C, Chave B, Gastaut JL. [A case of transient amnesia caused by cerebral thrombophlebitis: contribution of neuroimaging to physiopathogenesis of transient amnesia] Rev Neurol (Paris) 1995; 151:552-8.] Abstract: þ TGA Medline Results, 9/1/97