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Transient Global Amnesia (TGA) as First Presenting Sign of Neurodegenerative Disorders

Received: 15 September 2019    Accepted: 08 October 2019    Published: 17 October 2019
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Abstract

Transient global amnesia (TGA) is a clinical syndrome characterized by the sudden onset of anterograde amnesia, accompanied by repetitive questioning, sometimes with a retrograde component, lasting up to 24 hours, without compromise of other neurologic functions. Although various factors, such as migraine, focal ischemia, venous flow abnormalities, and epileptic phenomena, can be considered as involved in the pathophysiology and differential diagnosis of TGA, the factors triggering the emergence of these lesions are still elusive. Recent data suggest that the vulnerability of CA1 neurons to metabolic stress plays a pivotal part in the pathophysiological cascade, leading to an impairment of hippocampal function during TGA. We report three cases on neurodegenerative disorders presenting with transitory global amnesia, all evaluated at the department of emergency of Esine Hospital (Brescia), who developed all neurodegenerative disorders. It is important, when performing neurological evaluation in the department of emergency, to consider the possible presence of underlying cognitive impairment or behavioral symptoms especially in older people. Neurological evaluation should take into consideration the presence of piramidal, extrapiramidal or frontal sign release positivity or the presence of higher cortical functions impairment. It should be important to refer these patients to appropriate neurological evaluation in appropriate Centers for Neurodegenerative Disorders.

DOI 10.11648/j.cmr.20190805.14
Published in Clinical Medicine Research (Volume 8, Issue 5, September 2019)

This article belongs to the Special Issue Rare and Degenerative Disorders in Neurology

Page(s) 115-118
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Amnesia, Neurodegenerative, Emergency

References
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[2] Spiegel DR, Smith J, Wade RR, Cherukuru N, Ursani A, Dobruskina Y, Crist T, Busch RF, Dhanani RM, Dreyer N. Transient global amnesia: current perspectives. Neuropsychiatr Dis Treat. 2017 Oct 24; 13: 2691-2703.
[3] Courjon J, Guyotat J. [Amnesic strokes] J Med Lyon. 1956; 37: 697–701.
[4] Bartsch T, Deuschl G. Transient global amnesia: functional anatomy and clinical implications. Lancet Neurol. 2010 Feb; 9 (2): 205-14.
[5] Arena JE, Brown RD, Mandrekar J et al. Long-term outcome in patients with transient global amnesia: a population-based study. Mayo Clin Proc. 2017; 92 (3): 399–405.
[6] Bartsch T, Alfke K, Stingele R, et al. Selective affection of hippocampal CA-1 neurons in patients with transient global amnesia without long-term sequelae. Brain 2006; 129: 2874–84.
[7] Lewis SL. A etiology of transient global amnesia. Lancet 1998; 352: 397–99.
[8] Maalikjy Akkawi N, Agosti C, Anzola GP, Borroni B, Magoni M, Pezzini A, Rozzini L, Vignolo LA, Padovani A. Transient global amnesia: a clinical and sonographic study. Eur Neurol. 2003; 49 (2): 67-71.
[9] Della Marca G, Broccolini A, Vollono C, et al. The stolen memory: a case of transient global amnesia. Biol Psychiatry. 2009; 67: e31–2. [PubMed] [Google Scholar].
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[12] Kessler J, Markowitsch HJ, Rudolf J, Heiss WD. Continuing cognitive impairment after isolated transient global amnesia. Int J Neurosci. 2001; 106 (3-4): 159-68.
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Author Information
  • Neurology Unit, Azienda Socio Sanitaria Territoriale Valcamonica (Esine), Brescia, Italy

  • Department of Emergency and Urgency, Azienda Socio Sanitaria Territoriale Valcamonica (Esine), Brescia, Italy

  • Neurology Unit, Azienda Socio Sanitaria Territoriale Valcamonica (Esine), Brescia, Italy

  • Neurology Unit, Azienda Socio Sanitaria Territoriale Valcamonica (Esine), Brescia, Italy

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  • APA Style

    Cotelli Maria Sofia, Manelli Filippo, Tosana Elisa, Turla Marinella. (2019). Transient Global Amnesia (TGA) as First Presenting Sign of Neurodegenerative Disorders. Clinical Medicine Research, 8(5), 115-118. https://doi.org/10.11648/j.cmr.20190805.14

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    ACS Style

    Cotelli Maria Sofia; Manelli Filippo; Tosana Elisa; Turla Marinella. Transient Global Amnesia (TGA) as First Presenting Sign of Neurodegenerative Disorders. Clin. Med. Res. 2019, 8(5), 115-118. doi: 10.11648/j.cmr.20190805.14

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    AMA Style

    Cotelli Maria Sofia, Manelli Filippo, Tosana Elisa, Turla Marinella. Transient Global Amnesia (TGA) as First Presenting Sign of Neurodegenerative Disorders. Clin Med Res. 2019;8(5):115-118. doi: 10.11648/j.cmr.20190805.14

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  • @article{10.11648/j.cmr.20190805.14,
      author = {Cotelli Maria Sofia and Manelli Filippo and Tosana Elisa and Turla Marinella},
      title = {Transient Global Amnesia (TGA) as First Presenting Sign of Neurodegenerative Disorders},
      journal = {Clinical Medicine Research},
      volume = {8},
      number = {5},
      pages = {115-118},
      doi = {10.11648/j.cmr.20190805.14},
      url = {https://doi.org/10.11648/j.cmr.20190805.14},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.cmr.20190805.14},
      abstract = {Transient global amnesia (TGA) is a clinical syndrome characterized by the sudden onset of anterograde amnesia, accompanied by repetitive questioning, sometimes with a retrograde component, lasting up to 24 hours, without compromise of other neurologic functions. Although various factors, such as migraine, focal ischemia, venous flow abnormalities, and epileptic phenomena, can be considered as involved in the pathophysiology and differential diagnosis of TGA, the factors triggering the emergence of these lesions are still elusive. Recent data suggest that the vulnerability of CA1 neurons to metabolic stress plays a pivotal part in the pathophysiological cascade, leading to an impairment of hippocampal function during TGA. We report three cases on neurodegenerative disorders presenting with transitory global amnesia, all evaluated at the department of emergency of Esine Hospital (Brescia), who developed all neurodegenerative disorders. It is important, when performing neurological evaluation in the department of emergency, to consider the possible presence of underlying cognitive impairment or behavioral symptoms especially in older people. Neurological evaluation should take into consideration the presence of piramidal, extrapiramidal or frontal sign release positivity or the presence of higher cortical functions impairment. It should be important to refer these patients to appropriate neurological evaluation in appropriate Centers for Neurodegenerative Disorders.},
     year = {2019}
    }
    

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