Savage Sharon A, Butler Christopher R, Hodges John R, Zeman Adam Z
Cognitive & Behavioural Neurology, University of Exeter Medical School, College House, St. Luke's Campus, Exeter EX1 2LU, UK.
Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.
Seizure. 2016 Dec;43:48-55. doi: 10.1016/j.seizure.2016.10.022. Epub 2016 Nov 14.
Transient Epileptic Amnesia (TEA) is a form of adult onset temporal lobe epilepsy characterised by ictal amnesia. The amnesic seizures are often accompanied by interical memory disturbance, involving autobiographical amnesia and accelerated long-term forgetting. Short-term follow-up studies suggest a relatively stable cognitive profile once treated, but recent case reports raise concerns regarding the risk of developing Alzheimer's disease (AD). The current study reports clinical and cognitive outcome in TEA patients over a 20-year period.
A cohort of ten TEA patients first reported in 1998 were followed up at two time intervals, each 10 years apart. Information regarding clinical outcomes and subjective reports of memory functioning was gained via GP records and clinical interview. Objective memory function was determined at each time point via a comprehensive neuropsychological assessment, where possible.
Information was obtained for nine of the original 10 participants. Over the 20-year period, 4 participants died, with no indication of dementia prior to death. One participant was diagnosed with Vascular Dementia. Seizures were generally well controlled. Subjective reports of memory varied, including no concerns, stable memory difficulties, and worsening memory. Neuropsychological assessment at 10 years showed stable performances across most measures. At the 20-year follow up, there was no evidence of a general cognitive decline. Participants showed stability on some measures, with reductions on others. Performance was not consistent with AD.
No elevated risk of dementia was evident from this TEA series. Although memory difficulties persist over time, the prognosis of TEA appears generally benign.
短暂性癫痫性失忆症（TEA）是成人起病的颞叶癫痫的一种形式，其特征为发作性失忆。失忆性发作常伴有发作间期记忆障碍，包括自传体失忆和加速的长期遗忘。短期随访研究表明，一旦接受治疗，认知状况相对稳定，但近期的病例报告引发了对患阿尔茨海默病（AD）风险的担忧。本研究报告了TEA患者20年期间的临床和认知结局。
对1998年首次报告的10例TEA患者队列进行了两次随访，每次间隔10年。通过全科医生记录和临床访谈获取有关临床结局和记忆功能主观报告的信息。在每个时间点尽可能通过全面的神经心理学评估来确定客观记忆功能。
在最初的10名参与者中，有9名获得了相关信息。在20年期间，4名参与者死亡，死亡前无痴呆迹象。1名参与者被诊断为血管性痴呆。癫痫发作总体得到良好控制。记忆的主观报告各不相同，包括无担忧、记忆困难稳定以及记忆恶化。10年时的神经心理学评估显示，大多数指标的表现稳定。在20年随访时，没有证据表明存在总体认知衰退。参与者在某些指标上表现稳定，而在其他指标上有所下降。表现与AD不一致。
该TEA系列研究未发现痴呆风险升高。尽管记忆困难会持续存在，但TEA的预后总体上似乎是良性的。
