Hodges J R, Warlow C P
University Department of Clinical Neurology, Radcliffe Infirmary, Oxford, United Kingdom.
J Neurol Neurosurg Psychiatry. 1990 Oct;53(10):834-43. doi: 10.1136/jnnp.53.10.834.
Of 153 patients presenting with acute transient amnesia, 114 fulfilled the proposed strict diagnostic criteria for transient global amnesia (TGA). The prognosis of this group was excellent with the exception of a small subgroup (7%), largely identifiable because of atypically brief or recurrent attacks, who developed epilepsy of temporal lobe type on follow up. Computerised tomography (CT) scans performed on 95 patients were normal, evidence for covert alcoholism was lacking and there was a familial incidence of approximately 2%. By contrast, the group of 39 patients who did not meet the criteria for TGA had a significantly worse prognosis with a high incidence of major vascular events. The groups could not be distinguished on the basis of behavioural characteristics during the attack. The following classification was proposed: 1) pure TGA--attacks fulfilling the strict criteria, and of more than one hour in duration which do not require detailed investigation, 2) probable epileptic amnesia--attacks of less than an hour or rapidly recurrent, 3) probable transient ischaemic amnesia, a minority of cases with additional focal neurological deficits during the attack.
在153例急性短暂性失忆患者中，114例符合拟定的短暂性全面性失忆（TGA）严格诊断标准。除一小部分亚组患者（7%）外，该组患者预后良好，这一小部分患者主要因发作异常短暂或反复发作而被识别出来，随访时发展为颞叶型癫痫。对95例患者进行的计算机断层扫描（CT）结果正常，没有隐匿性酒精中毒的证据，且家族发病率约为2%。相比之下，39例不符合TGA标准的患者预后明显较差，主要血管事件发生率很高。根据发作期间的行为特征无法区分这两组患者。提出了以下分类：1）纯TGA——发作符合严格标准，持续时间超过一小时，无需详细检查；2）可能的癫痫性失忆——发作持续时间少于一小时或迅速复发；3）可能的短暂性缺血性失忆，少数病例在发作期间伴有额外的局灶性神经功能缺损。
