Abstract:
Transient global amnesia (TGA) is characterized by sudden and temporary memory impairment, while transient epileptic amnesia (TEA) represents amnestic attacks as the main manifestation of focal epilepsy with presumed temporal origin. We present a 48-year-old patient who experienced transient amnesia 10 weeks after right selective amygdalo-hippocampectomy for right temporal lobe epilepsy. Despite TEA being a plausible explanation for amnesia in patients with temporal lobe epilepsy, no epileptiform discharges were found during the amnestic episode and key features indicative of TGA, including long duration, isolated occurrence, and dense anterograde amnesia of the episode, argued against a diagnosis of TEA in this case. Notably, the patient has remained seizure-free (now 4,5 years) and stopped taking antiseizure medication 32 months after surgery. Although TGA clinical criteria formally exclude patients with recent active epilepsy, neurologists should be aware that TGA can occur after epilepsy surgery in the temporal lobe. Therefore, we consider it of high clinical relevance to establish a careful differential diagnosis between TGA and epileptic amnestic attacks after epilepsy surgery to avoid unnecessary reintroduction or continuation of antiseizure medication. Additionally, this case presents the first comparison of detailed neuropsychological test results before and after a presumed TGA episode, revealing a complete recovery of anterograde memory functions within 1 day. PLAIN LANGUAGE SUMMARY: A 48-year-old patient experienced an episode of transient amnesia 10 weeks after epilepsy surgery. Given the patient\'s history, an epileptic origin of the episode initially seemed likely. However, tests revealed no seizure activity during the episode and the characteristics matched a condition called transient global amnesia. This case highlights the importance of correctly diagnosing memory impairments after epilepsy surgery to prevent unnecessary treatment.
摘要:
短暂性全球健忘症(TGA)的特点是突然和暂时的记忆障碍,而短暂性癫痫性健忘症(TEA)代表遗忘发作是局灶性癫痫的主要表现,假定是颞叶起源。我们介绍了一名48岁的患者,该患者在右选择性杏仁核-海马切除术治疗右颞叶癫痫10周后经历了短暂性健忘症。尽管TEA是颞叶癫痫患者健忘症的合理解释,在遗忘发作期间未发现癫痫样放电,并提示TGA的关键特征,包括长时间,孤立的事件,和密集的顺行性健忘症,在这种情况下反对TEA的诊断。值得注意的是,患者在手术后32个月仍未出现癫痫发作(现为4.5年),并停止服用抗癫痫药物.尽管TGA临床标准正式排除近期活动性癫痫患者,神经科医师应注意,颞叶癫痫手术后可发生TGA.因此,我们认为,在癫痫手术后TGA和癫痫记忆缺失发作之间建立仔细的鉴别诊断具有高度的临床意义,以避免不必要的再次使用或继续使用抗癫痫药物.此外,该病例首次比较了假定的TGA发作前后的详细神经心理学测试结果,显示1天内完全恢复顺行记忆功能。简单语言总结:一名48岁的患者在癫痫手术后10周出现一过性健忘症。根据病人的病史,最初似乎可能是癫痫发作的起源。然而,测试显示,在发作期间没有癫痫发作活动,其特征与称为短暂性全球健忘症的情况相匹配。此病例强调了正确诊断癫痫手术后记忆障碍的重要性,以防止不必要的治疗。