Gallassi R, Morreale A, Di Sarro R, Lugaresi E
Institute of Neurology, University of Bologna, Italy.
Epilepsia. 1992;33 Suppl 6:S21-5.
Thirteen patients with "epileptic amnesic syndrome" (EAS) presented with adult-senile onset of a severe memory complaint that started before or at the same time as seizures. All were diagnosed as temporal lobe epilepsy (TLE). The seizures were stereotyped, with only short loss of contact and oral automatisms, and because they were not obvious or disturbing, they remained underdiagnosed for a long time. Nine cases also presented attacks of transient anteroretrograde amnesia after the seizures--called "epileptic amnesic attacks" (EAA)--during which the patients were able to perform complex actions. EAA are similar to the attacks of transient global amnesia (TGA) but are more frequent, shorter, accompanied by clear-cut clinical and electroencephalographic epileptic manifestations, and respond favorably to antiepileptic therapy. Neuropsychological investigation ruled out global mental deterioration, showing only selective memory impairment in a few long-term tasks and dissociation between formal findings and the relevant memory complaint. These cases have uniform anamnestic, clinical, and neuropsychological characteristics and represent a particular clinical expression of TLE, namely EAS. We suggest that an epileptic origin be entertained in patients presenting repeated amnesic attacks resembling TGA or who complain of persistent memory disturbance, after more common etiologies have been excluded.
13例“癫痫性遗忘综合征”（EAS）患者表现为成年至老年期起病的严重记忆障碍，该症状在癫痫发作之前或同时出现。所有患者均被诊断为颞叶癫痫（TLE）。癫痫发作形式刻板，仅有短暂的意识中断和口部自动症，由于发作不明显或未造成困扰，长期以来一直未得到充分诊断。9例患者在癫痫发作后还出现了短暂的顺行性和逆行性遗忘发作——称为“癫痫性遗忘发作”（EAA）——发作期间患者能够进行复杂动作。EAA与短暂性全面遗忘症（TGA）发作相似，但更为频繁、持续时间更短，伴有明确的临床和脑电图癫痫表现，对抗癫痫治疗反应良好。神经心理学检查排除了整体智力衰退，仅在一些长期任务中显示出选择性记忆损害，且形式检查结果与相关记忆障碍之间存在分离。这些病例具有一致的既往史、临床和神经心理学特征，代表了TLE的一种特殊临床表型，即EAS。我们建议，在排除更常见病因后，对于出现类似TGA的反复遗忘发作或主诉持续性记忆障碍的患者，应考虑癫痫起源。
