The University of Western Australia, Nedlands, Australia.
Neurodegenerative Disorders Research Pty Ltd, 4 Lawrence Avenue, West Perth, Western Australia, 6005.
BMC Neurol. 2020 Mar 6;20(1):83. doi: 10.1186/s12883-020-01658-8.
Aetiology of transient global amnesia (TGA) remains uncertain, though many have been proposed, including ischaemic, migrainous or epileptic pathologies.
We attempted to determine risk factors for TGA, as well as prognostic factors that may cause recurrence. We evaluated clinical history, family history and magnetic resonance diffusion-weighted imaging (DWI) studies of 93 prospective patients with TGA. Patients were followed from 2004 to 2016. Fifteen of 93 (16%) patients experienced a recurrence of TGA.
Among precipitating events, physical activities inducing Valsalva-like manoeuvres were most common, followed by emotional stress. Eighty-four patients had possible comorbidities or risk factors for TGA, though no single risk factor was ubiquitous. Risk factors associated with recurrence were head injury (isolated vs. recurrent, 16.7% vs. 53.5%, p < 0.01), depression (isolated vs. recurrent, 15.4% vs 46.7%, p = 0.01) and family history of dementia (isolated vs. recurrent, 20.5% vs. 46.7%, p = 0.03). Of 15 patients with confirmed recurrent TGA, two developed dementia and four subjective memory impairment. DWI lesions were observed in 24 patients and were located anywhere within the hippocampus.
DWI lesions were not significantly associated with outcomes (recurrence, subjective memory impairment, dementia). We have found that depression, previous head injury and family history of dementia may predict TGA recurrence.
短暂性全面遗忘症（TGA）的病因仍不确定，尽管有许多假说，包括缺血性、偏头痛或癫痫性病变。
我们试图确定 TGA 的危险因素以及可能导致复发的预后因素。我们评估了 93 例 TGA 前瞻性患者的临床病史、家族史和磁共振弥散加权成像（DWI）研究。患者从 2004 年到 2016 年进行随访。93 例患者中有 15 例（16%）复发 TGA。
在诱发事件中，最常见的是引起瓦尔萨尔瓦动作的体力活动，其次是情绪压力。84 例患者存在 TGA 的可能合并症或危险因素，但没有单一的危险因素普遍存在。与复发相关的危险因素包括头部外伤（孤立性 vs. 复发性，16.7% vs. 53.5%，p<0.01）、抑郁（孤立性 vs. 复发性，15.4% vs. 46.7%，p=0.01）和痴呆家族史（孤立性 vs. 复发性，20.5% vs. 46.7%，p=0.03）。在 15 例确诊复发性 TGA 患者中，有 2 例发展为痴呆，4 例出现主观记忆障碍。24 例患者出现 DWI 病变，位于海马体任何部位。
DWI 病变与结局（复发、主观记忆障碍、痴呆）无显著相关性。我们发现抑郁、既往头部外伤和痴呆家族史可能预测 TGA 复发。
