Oliveira Renato, Teodoro Tomás, Marques Inês Brás
Department of Neurology, Hospital da Luz Lisboa, Avenida Lusíada 100, 1500-650, Lisbon, Portugal.
Headache Center, Hospital da Luz Lisboa, Lisbon, Portugal.
Neurol Sci. 2021 May;42(5):2039-2043. doi: 10.1007/s10072-020-04788-6. Epub 2020 Oct 8.
To assess risk factors of transient global amnesia (TGA) recurrence.
Retrospective study of a case series of patients with the diagnosis of TGA in our neurology center in the last 8 years, identified through an anonymized database search. TGA was identified by applying Hodges and Warlow criteria.
Seventy patients (70% female, average age 64.8 ± 7.8 years) were enrolled; mean follow-up was 16.5 months. More frequent co-morbidities were hypertension (50%), depression (25.7%), diabetes mellitus (17.1%), migraine (15.7%), and cerebrovascular disease (8.6%). Average TGA episode duration was 4 h. Forty-one percent had an identifiable trigger-emotional stress (25.7%), physical effort (8.6%), and sexual intercourse (4.3%). Five patients (7.1%) had hippocampus restriction on diffusion weighted MRI. Nineteen patients (27.1%) had TGA recurrence. Patients with recurrent TGA were more likely to be female and have history of depression, shorter duration episode, and hippocampus hyperintensity on brain MRI. None of the other clinical characteristics and complementary studies were predictors of recurrence. In the multivariate analysis, history of depression was the only factor found to predict which patients had a higher risk of recurrence.
We present a cohort of TGA patients with a considerable recurrent rate (27%), alerting for the possibility of recurrence of this clinical entity. TGA recurrence was associated with the following factors: female sex, depression, shorter episode duration, and hippocampal hyperintensity on brain MRI. History of depression was found to be the most important recurrence predictor in our study.
评估短暂性全面性遗忘症（TGA）复发的危险因素。
通过匿名数据库搜索，对过去8年在我们神经科中心确诊为TGA的一系列病例进行回顾性研究。TGA通过应用霍奇斯和沃洛标准进行确诊。
纳入70例患者（70%为女性，平均年龄64.8±7.8岁）；平均随访时间为16.5个月。较常见的合并症有高血压（50%）、抑郁症（25.7%）、糖尿病（17.1%）、偏头痛（15.7%）和脑血管疾病（8.6%）。TGA发作的平均持续时间为4小时。41%的患者有可识别的诱发因素——情绪应激（25.7%）、体力活动（8.6%）和性交（4.3%）。5例患者（7.1%）在弥散加权磁共振成像上显示海马受限。19例患者（27.1%）出现TGA复发。复发TGA的患者更可能为女性，有抑郁症病史，发作持续时间较短，且脑磁共振成像显示海马高强度信号。其他临床特征和辅助检查均不是复发的预测因素。在多变量分析中，抑郁症病史是唯一被发现可预测哪些患者复发风险较高的因素。
我们呈现了一组TGA复发率相当高（27%）的患者队列，警示了这一临床实体复发的可能性。TGA复发与以下因素相关：女性、抑郁症、发作持续时间较短以及脑磁共振成像显示海马高强度信号。在我们的研究中，抑郁症病史被发现是最重要的复发预测因素。
