Kister Ilya
NYU Multiple Sclerosis Comprehensive Care Center, Department of Neurology, New York University Grossman School of Medicine, New York, NY, 10016, USA.
Curr Neurol Neurosci Rep. 2025 Sep 19;25(1):64. doi: 10.1007/s11910-025-01455-1.
To outline a practical and comprehensive approach to evaluating transient neurologic dysfunction (TND) in adults.
TNDs are a common reason for neurologic consultation. Diagnosis relies largely on history, as neurologic examination is usually normal in the post-ictal stage. The differential of TNDs is extensive, and testing should be targeted to the more likely etiologies and ones that may portend permanent loss of neurologic function. In addition to the more common causes - transient ischemic attack (TIA), seizures, migraine auras, drug-induced adverse events, hypoglycemia, blood pressure fluctuations, hyperventilation, panic attacks, and paroxysmal vestibular disorders, there are some distinctive TND presentations and special circumstances that may point to the less common etiologies. The article outlines the key features of the common presentations and presents a comprehensive differential diagnosis that includes many rare causes of TNDs in adults and adolescents. The proposed approach relies on carefully elucidating the nature, timeline, and circumstances of the symptoms, gathering examination clues, and seeking to determine whether the event is likely due to neuro-vascular, non-vascular neurologic (paroxysmal or chronic), non-neurologic, or rare neurologic etiologies. Specific diagnoses are listed for each of these categories.
概述一种评估成人短暂性神经功能障碍（TND）的实用且全面的方法。
TND是神经科会诊的常见原因。诊断很大程度上依赖于病史，因为发作后阶段的神经系统检查通常正常。TND的鉴别诊断范围广泛，检查应针对更可能的病因以及可能预示神经功能永久性丧失的病因。除了更常见的病因——短暂性脑缺血发作（TIA）、癫痫发作、偏头痛先兆、药物引起的不良事件、低血糖、血压波动、过度换气、惊恐发作和阵发性前庭障碍外，还有一些独特的TND表现和特殊情况可能指向不太常见的病因。本文概述了常见表现的关键特征，并提出了一个全面的鉴别诊断，包括成人和青少年TND的许多罕见病因。所提出的方法依赖于仔细阐明症状的性质、时间线和情况，收集检查线索，并试图确定该事件是否可能归因于神经血管性、非血管性神经（阵发性或慢性）、非神经性或罕见的神经病因。针对这些类别中的每一类都列出了具体诊断。
