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The Prognosis of Transient Global Amnesia: Results of a Multicenter Study

The Prognosis of Transient Global Amnesia: Results of a Multicenter Study Abstract • In a Danish multicenter study, 74 patients 20 to 75 years of age (mean age, 58.8 years) with transient global amnesia (TGA) without accompanying major neurological signs were studied. Over a follow-up period ranging from seven to 210 months (mean, 66.6 months) the observed rates of death and cerebrovascular morbidity were similar to those expected in the Danish population, matched for age and sex. Sixteen patients (22%) had further TGAs occurring one month to nine years after the original episode; the mean annual recurrence rate was 4.7%. We concluded that TGA without associated major neurological deficits is a benign clinical phenomenon, probably caused by a functional cerebral disturbance unrelated to cerebrovascular disease in general. Furthermore, the observed temporal pattern of recurrence suggests that, although TGA is in principle a recurrent disorder, the annual risk of recurrence is so low that most of the elderly patients are likely to experience only one attack. References 1. Bender M: Syndrome of isolated episode of confusion with amnesia . J Hillside Hosp 1956;5:212-215. 2. Caplan LB: Transient global amnesia , in Frederiks JAM (ed): Handbook of Clinical Neurology . Amsterdam, Elsevier Science Publishers, 1985, vol 1, pp 205-218. 3. Fisher CM, Adams RD: Transient global amnesia . Acta Neurol Scand 1964;40( (suppl 9) ):7-82.Crossref 4. Heathfield KWG, Croft PB, Swash M: The syndrome of transient global amnesia . Brain 1973;96:729-736.Crossref 5. Jensen TS, de Fine Olivarius B: Transient global amnesia: Its clinical and pathophysiological basis and prognosis . Acta Neurol Scand 1981;63:220-230.Crossref 6. Crowell FG, Stump DA, Biller J, et al: The transient global amnesia-migraine connection . Arch Neurol 1984;41:75-79.Crossref 7. Jensen TS, de Fine Olivarius B: Transient global amnesia as a manifestation of transient cerebral ischemia . Acta Neurol Scand 1980;61:115-124.Crossref 8. Mathew N, Meyer JS: Pathogenesis and natural history of transient global amnesia . Stroke 1974;5:303-311.Crossref 9. Nausieda PA, Sherman IC: Long-term prognosis in transient global amnesia . JAMA 1979;241:392-393.Crossref 10. Shuping JR, Rollinson RD, Toole JF: Transient global amnesia . Ann Neurol 1980;7:281-285.Crossref 11. Cattaino G, Querin F, Pomes A, et al: Transient global amnesia . Acta Neurol Scand 1984;70:385-390.Crossref 12. Godlewski S: Les épisodes amnésiques (transient global amnesia): Étude clinique basée sur 33 observations inédites . Semin Hop Paris 1968;44:553-577. 13. Kannel WB, Blaisdell FW, Gifford R: Risk factors in stroke due to cerebral infarction . Stroke 1971;2:423-428.Crossref 14. Hansen BS, Marquardsen J: Incidence of stroke in Frederiksberg, Denmark . Stroke 1977;8:663-665.Crossref 15. Scoville WB, Milner B: Loss of recent memory after bilateral hippocampus lesions . J Neurol Neurosurg Psychiatry 1957;20:11-21.Crossref 16. Victor M, Angerine JB, Mancall EL, et al: Memory loss with lesions of hippocampal formation . Arch Neurol 1961;5:244-261.Crossref 17. Zola-Morgan S, Squire LR, Mishkin MI: The neuroanatomy of amnesia: Amygdala-hippocampus vs temporal stem . Science 1982;218:1337-1339.Crossref 18. Cummings JL, Tomiyasu U, Read S, et al: Amnesia with hippocampal lesions after cardiopulmonary arrest . Neurology 1984;34:679-681.Crossref 19. Damasio AR, Graff-Radford NR, Eslinger PJ, et al: Amnesia following basal forebrain lesions . Arch Neurol 1985;42:263-271.Crossref 20. Duyckaerts C, Derouesne C, Signoret JL, et al: Bilateral and limited amygdalo-hippocampal lesions causing a pure amnesic syndrome . Ann Neurol 1985;18:314-319.Crossref 21. Benson DF, Marsden CD, Meadows JC: The amnesic syndrome of posterior cerebral artery occlusion . Acta Neurol Scand 1974;50:133-145.Crossref 22. Caplan L, Chedru F, Lhermitte F, et al: Transient global amnesia and migraine . Neurology 1981;31:1167-1170.Crossref 23. De Fine Olivarius B, Jensen TS: Transient global amnesia in migraine . Headache 1979;19:335-338.Crossref 24. Jensen TS: Transient global amnesia in childhood . Dev Med Child Neurol 1980;22:654-658. 25. Lauritzen M, Olsen TS, Lassen NA, et al: The changes of regional cerebral blood flow during the course of classical migraine attacks . Ann Neurol 1983;16:463-471. 26. Lauritzen M, Jørgensen MB, Diemer NH, et al: Persistent oligemia of rat cerebral cortex in the wake of spreading depression . Ann Neurol 1982;12:469-474.Crossref 27. Leao AAP: Spreading depression of activity in the cerebral cortex . J Neurophysiol 1944;7:359-390. 28. Olesen J, Jørgensen MB: Hypothesis: Leao's spreading depression in the hippocampus explains transient global amnesia. Acta Neurol Scand, in press. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

The Prognosis of Transient Global Amnesia: Results of a Multicenter Study

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Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1986.00520070031013
Publisher site
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Abstract

Abstract • In a Danish multicenter study, 74 patients 20 to 75 years of age (mean age, 58.8 years) with transient global amnesia (TGA) without accompanying major neurological signs were studied. Over a follow-up period ranging from seven to 210 months (mean, 66.6 months) the observed rates of death and cerebrovascular morbidity were similar to those expected in the Danish population, matched for age and sex. Sixteen patients (22%) had further TGAs occurring one month to nine years after the original episode; the mean annual recurrence rate was 4.7%. We concluded that TGA without associated major neurological deficits is a benign clinical phenomenon, probably caused by a functional cerebral disturbance unrelated to cerebrovascular disease in general. Furthermore, the observed temporal pattern of recurrence suggests that, although TGA is in principle a recurrent disorder, the annual risk of recurrence is so low that most of the elderly patients are likely to experience only one attack. References 1. Bender M: Syndrome of isolated episode of confusion with amnesia . J Hillside Hosp 1956;5:212-215. 2. Caplan LB: Transient global amnesia , in Frederiks JAM (ed): Handbook of Clinical Neurology . Amsterdam, Elsevier Science Publishers, 1985, vol 1, pp 205-218. 3. Fisher CM, Adams RD: Transient global amnesia . Acta Neurol Scand 1964;40( (suppl 9) ):7-82.Crossref 4. Heathfield KWG, Croft PB, Swash M: The syndrome of transient global amnesia . Brain 1973;96:729-736.Crossref 5. Jensen TS, de Fine Olivarius B: Transient global amnesia: Its clinical and pathophysiological basis and prognosis . Acta Neurol Scand 1981;63:220-230.Crossref 6. Crowell FG, Stump DA, Biller J, et al: The transient global amnesia-migraine connection . Arch Neurol 1984;41:75-79.Crossref 7. Jensen TS, de Fine Olivarius B: Transient global amnesia as a manifestation of transient cerebral ischemia . Acta Neurol Scand 1980;61:115-124.Crossref 8. Mathew N, Meyer JS: Pathogenesis and natural history of transient global amnesia . Stroke 1974;5:303-311.Crossref 9. Nausieda PA, Sherman IC: Long-term prognosis in transient global amnesia . JAMA 1979;241:392-393.Crossref 10. Shuping JR, Rollinson RD, Toole JF: Transient global amnesia . Ann Neurol 1980;7:281-285.Crossref 11. Cattaino G, Querin F, Pomes A, et al: Transient global amnesia . Acta Neurol Scand 1984;70:385-390.Crossref 12. Godlewski S: Les épisodes amnésiques (transient global amnesia): Étude clinique basée sur 33 observations inédites . Semin Hop Paris 1968;44:553-577. 13. Kannel WB, Blaisdell FW, Gifford R: Risk factors in stroke due to cerebral infarction . Stroke 1971;2:423-428.Crossref 14. Hansen BS, Marquardsen J: Incidence of stroke in Frederiksberg, Denmark . Stroke 1977;8:663-665.Crossref 15. Scoville WB, Milner B: Loss of recent memory after bilateral hippocampus lesions . J Neurol Neurosurg Psychiatry 1957;20:11-21.Crossref 16. Victor M, Angerine JB, Mancall EL, et al: Memory loss with lesions of hippocampal formation . Arch Neurol 1961;5:244-261.Crossref 17. Zola-Morgan S, Squire LR, Mishkin MI: The neuroanatomy of amnesia: Amygdala-hippocampus vs temporal stem . Science 1982;218:1337-1339.Crossref 18. Cummings JL, Tomiyasu U, Read S, et al: Amnesia with hippocampal lesions after cardiopulmonary arrest . Neurology 1984;34:679-681.Crossref 19. Damasio AR, Graff-Radford NR, Eslinger PJ, et al: Amnesia following basal forebrain lesions . Arch Neurol 1985;42:263-271.Crossref 20. Duyckaerts C, Derouesne C, Signoret JL, et al: Bilateral and limited amygdalo-hippocampal lesions causing a pure amnesic syndrome . Ann Neurol 1985;18:314-319.Crossref 21. Benson DF, Marsden CD, Meadows JC: The amnesic syndrome of posterior cerebral artery occlusion . Acta Neurol Scand 1974;50:133-145.Crossref 22. Caplan L, Chedru F, Lhermitte F, et al: Transient global amnesia and migraine . Neurology 1981;31:1167-1170.Crossref 23. De Fine Olivarius B, Jensen TS: Transient global amnesia in migraine . Headache 1979;19:335-338.Crossref 24. Jensen TS: Transient global amnesia in childhood . Dev Med Child Neurol 1980;22:654-658. 25. Lauritzen M, Olsen TS, Lassen NA, et al: The changes of regional cerebral blood flow during the course of classical migraine attacks . Ann Neurol 1983;16:463-471. 26. Lauritzen M, Jørgensen MB, Diemer NH, et al: Persistent oligemia of rat cerebral cortex in the wake of spreading depression . Ann Neurol 1982;12:469-474.Crossref 27. Leao AAP: Spreading depression of activity in the cerebral cortex . J Neurophysiol 1944;7:359-390. 28. Olesen J, Jørgensen MB: Hypothesis: Leao's spreading depression in the hippocampus explains transient global amnesia. Acta Neurol Scand, in press.

Journal

Archives of NeurologyAmerican Medical Association

Published: Jul 1, 1986

References