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急诊科短暂性全面性遗忘症的诊断与处理

The diagnosis and management of transient global amnesia in the emergency department.

作者信息

Harrison Magnus, Williams Mark

机构信息

University Hospital of North Staffordshire NHS Trust, North Staffordshire Royal Infirmary, Princes Road, Stoke-on-Trent, Staffordshire ST4 7LN, UK.

出版信息

Emerg Med J. 2007 Jun;24(6):444-5. doi: 10.1136/emj.2007.046565.

Abstract

Transient Global Amnesia (TGA) is a benign and temporary loss of anterograde memory with the preservation of remote memories and immediate recall. TGA was first described in 1956 and since then epilepsy, transient ischaemic attacks (TIA), migraine and now intracranial venous stasis have been implicated in its aetiology. Precipitants of TGA include physical exertion and valsalva-like manoeuvres. In order to diagnose TGA the criteria created by Hodge and Warlow in 1990 can be used. This requires the episode of memory loss to be witnessed and involve anterograde amnesia. The patient must not have any evidence of neurological signs or deficits, features of epilepsy, active epilepsy or recent head injury. Finally the episode must have resolved within 24 h. In this case study the patient's symptoms are mistakenly attributed to a TIA. There is no increased risk of TIA or CVA in patients who have had TGA and there are no increased levels of mortality amongst these patients. In this article we aim to help doctors working in the emergency department to diagnose and manage TGA.

摘要

短暂性全面性遗忘症(TGA)是一种良性且暂时性的顺行性记忆丧失,远期记忆和即刻回忆得以保留。TGA于1956年首次被描述,自那时起,癫痫、短暂性脑缺血发作(TIA)、偏头痛以及如今的颅内静脉淤滞都被认为与它的病因有关。TGA的诱发因素包括体力活动和类似瓦尔萨尔瓦动作。为了诊断TGA,可以采用1990年霍奇和沃洛制定的标准。这要求记忆丧失发作有旁人见证且涉及顺行性遗忘。患者不得有任何神经体征或缺陷、癫痫特征、活动性癫痫或近期头部受伤的证据。最后,发作必须在24小时内缓解。在本病例研究中,患者的症状被错误地归因于TIA。患过TGA的患者发生TIA或脑卒中的风险并未增加,这些患者的死亡率也没有升高。在本文中,我们旨在帮助急诊科医生诊断和处理TGA。

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本文引用的文献

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Transient global amnesia following a transoceanic flight.
Psychiatry Clin Neurosci. 2006 Aug;60(4):516-20. doi: 10.1111/j.1440-1819.2006.01539.x.
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Transient global amnesia: diagnosis in the emergency department.
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