Naranjo-Fernández Cristina, Arjona Antonio, Quiroga-Subirana Pablo, Payán-Ortiz Manuel, Guardado-Santervás Pedro, Serrano-Castro Pedro J, Aguilera-Del Moral Almudena
Hospital Torrecardenas, 04009 Almeria, Espana.
Rev Neurol. 2010;50(4):217-20.
Impaired memory, and more particularly spatial orientation, occurs in pathologies such as dementia, cerebrovascular accidents or traumatic brain injuries. Less frequently it also appears as a transient disorder in healthy people with no apparent brain damage, in which case it is known as transient topographical amnesia (TTA). The aim of this work is to report on a series of eight cases of TTA that were evaluated in a neurology unit.
We study the cases of eight patients diagnosed with TTA over the period 2002-2008. Patients were considered to fulfil eligibility criteria if they had presented at least one episode of spatial disorientation, with no loss of memory or consciousness, and were able to describe the events that had taken place, without any previous cognitive impairment and with a normal neurological examination. The demographic characteristics taken into account in the study were: predominance of females (75%) and a mean age of 69.13 +/- 8.79 years. The mean number of episodes was 1.75 (range: 1-3), which lasted an average of 24.5 minutes. Three of the eight patients had associated vascular risk factors. Neuroimaging studies did not reveal any relevant findings in any of the eight patients, except one case of a bilateral frontal porencephalic area resulting from a traumatic brain injury suffered in the past. Simple single-photon emission tomography and Doppler ultrasound imaging scans of the brain, as well as an electroencephalogram, were performed on two patients, the results being normal in all cases. Follow-ups were performed on all the patients, without any kind clinical change being observed, except for one patient who developed dementia at six years after the episode of amnesia.
TTA is possibly an underdiagnosed condition which we believe should be included in the differential diagnosis of patients who are referred owing to suspected cognitive impairment.
记忆力受损，尤其是空间定向能力受损，见于痴呆、脑血管意外或创伤性脑损伤等疾病。在没有明显脑损伤的健康人中，这种情况较少见，表现为短暂性障碍，此时称为短暂性地形性遗忘症（TTA）。本文旨在报告在神经科病房评估的一系列8例TTA病例。
我们研究了2002年至2008年期间诊断为TTA的8例患者。如果患者至少出现过一次空间定向障碍发作，无记忆丧失或意识丧失，能够描述所发生的事件，既往无认知障碍且神经检查正常，则认为符合入选标准。研究中考虑的人口统计学特征为：女性占主导（75%），平均年龄69.13±8.79岁。发作次数平均为1.75次（范围：1 - 3次），持续时间平均为24.5分钟。8例患者中有3例伴有血管危险因素。除1例因既往创伤性脑损伤导致双侧额叶脑穿通畸形外，8例患者的神经影像学检查均未发现任何相关异常。对2例患者进行了简单的单光子发射断层扫描和脑多普勒超声成像扫描以及脑电图检查，结果均正常。对所有患者进行了随访，除1例患者在遗忘症发作6年后发展为痴呆外，未观察到任何临床变化。
TTA可能是一种诊断不足的疾病，我们认为在因疑似认知障碍而转诊的患者的鉴别诊断中应考虑该病。
