Nakamizo Tomoki, Tsuzuki Ippei, Koide Takashi
Department of Neurology, Hiratsuka City Hospital, 1-19-1 Minamihara, Hiratsuka, Kanagawa 254-0065, Japan.
Case Rep Neurol Med. 2015;2015:541328. doi: 10.1155/2015/541328. Epub 2015 Nov 30.
Transient global amnesia (TGA) is a self-limited disease characterized by isolated amnesia, which resolves within 24 h. In contrast, posterior reversible encephalopathy syndrome (PRES) is a potentially life-threatening disease that usually presents with seizures, altered mental status, headache, and visual disturbances. It is characterized by reversible vasogenic edema that predominantly involves the parieto-occipital subcortical white matter as shown by neuroimaging studies. To date, there have been no reported cases of PRES with a clinical course resembling TGA. Here we report the case of a 58-year-old woman who presented with isolated amnesia and headache. On admission, her blood pressure was 187/100 mmHg. She had complete anterograde amnesia and slight retrograde amnesia without other neurological findings. After the treatment of her hypertension, the amnesia resolved within 24 h. Although the initial magnetic resonance image (MRI) was almost normal, the fluid attenuation inversion recovery (FLAIR) images of the MRI on the next day revealed several small foci of high intensity areas in the fronto-parieto-occipital subcortical white matter, presumed to be vasogenic edema in PRES. The lesions disappeared one month later. This case suggests that PRES can mimic the clinical course of TGA. PRES should be considered in the differential diagnosis for TGA.
短暂性全面性遗忘症（TGA）是一种以孤立性遗忘为特征的自限性疾病，症状在24小时内缓解。相比之下，后部可逆性脑病综合征（PRES）是一种潜在的危及生命的疾病，通常表现为癫痫发作、精神状态改变、头痛和视觉障碍。其特征是可逆性血管源性水肿，神经影像学研究显示主要累及顶枕叶皮质下白质。迄今为止，尚无PRES临床病程类似TGA的病例报道。在此，我们报告一例58岁女性，表现为孤立性遗忘和头痛。入院时，她的血压为187/100 mmHg。她存在完全性顺行性遗忘和轻度逆行性遗忘，无其他神经系统体征。高血压治疗后，遗忘症状在24小时内缓解。虽然初始磁共振成像（MRI）基本正常，但次日MRI的液体衰减反转恢复（FLAIR）图像显示额顶枕叶皮质下白质有几个小的高强度区域病灶，推测为PRES中的血管源性水肿。这些病灶在1个月后消失。该病例提示PRES可模仿TGA的临床病程。在TGA的鉴别诊断中应考虑PRES。
