Department of Neurology, Memory Disorders Group, University Hospital Schleswig-Holstein, University of Kiel, Schittenhelmstrasse 10, 24105 Kiel, Germany.
Nat Rev Neurol. 2013 Feb;9(2):86-97. doi: 10.1038/nrneurol.2012.264. Epub 2013 Jan 8.
Transient amnesic syndromes are striking clinical phenomena that are commonly encountered by physicians in acute medical settings. Diagnosis of such syndromes can be challenging, and their causes have been debated for over 50 years. Critical clinical distinctions, such as between transient global amnesia (TGA) and transient epileptic amnesia (TEA), as well as important clues to the underlying pathophysiology, have recently been revealed. TGA is characterized by the sudden onset of a profound anterograde and retrograde amnesia that lasts for up to 24 h, with neuroimaging after an acute TGA event showing transient perturbation of specific hippocampal circuits that are involved in memory processing. Some cases of transient amnesia are attributable to focal seizure activity and are termed TEA, which has a clinical presentation similar to that of TGA, but can be distinguished from the latter by the brevity and frequency of amnesic attacks. Moreover, TEA carries a risk of persistent memory impairment that can be mistaken for dementia. Here, we summarize clinically relevant aspects of transient amnesic syndromes, giving practical recommendations for diagnosis and patient management. We describe results from imaging and epidemiological studies that have shed light on the functional anatomy and pathophysiological mechanisms underlying these conditions.
短暂性遗忘综合征是一种显著的临床现象，在急性医疗环境中，医生经常会遇到。此类综合征的诊断具有一定挑战性，其病因已有 50 多年的争议。最近，人们揭示了一些重要的临床区别，如短暂性全面遗忘症（TGA）和短暂性癫痫性遗忘症（TEA）之间的区别，以及潜在病理生理学的重要线索。TGA 的特征是突然出现严重的顺行性和逆行性遗忘，持续时间长达 24 小时，急性 TGA 事件后的神经影像学显示，特定海马回路的短暂扰动与记忆处理有关。一些短暂性遗忘症归因于局灶性癫痫活动，被称为 TEA，其临床表现与 TGA 相似，但可通过遗忘发作的短暂性和频率与后者相区别。此外，TEA 存在持续记忆障碍的风险，可能被误诊为痴呆。在这里，我们总结了短暂性遗忘综合征的临床相关方面，为诊断和患者管理提供了实用建议。我们描述了影像学和流行病学研究的结果，这些结果揭示了这些病症的功能解剖和病理生理学机制。
