Abstracts

RATIONALE: Epilepsy is an infrequent cause of the syndrome of transient global amnesia (TGA). The purpose of this study is to summarize the clinical features, neuro-imaging results, and electroencephalogram (EEG) findings seen in patients presenting with epilepsy-related transient amnesia (termed transient epileptic amnesia (TEA)). METHODS: The medical records of seven patients with epilepsy with episodes of transient amnesia as the presenting complaint were reviewed. RESULTS: The mean patient age was 53 years (range,26-74 years). The mean number of amnestic episodes occurring prior to diagnosis was 6.1 (range, 2-20). The duration of the amnestic episodes ranged from three minutes to 8 hours. Six patients were noted to repetitively ask the same questions during their episodes. No other seizure manifestations were reported by witnesses in any of these cases. Five patients sought emergency medical attention after their initial episode. Risk factors for epilepsy were present in two patients (prior head injury in one, febrile seizures in another). In all seven patients, the neurological examination was normal and magnetic resonance imaging failed to disclose a causative lesion. Temporal region epileptiform discharges were eventually identified on EEG in six patients. EEG abnormalities were not noted in the seventh patient, who was diagnosed based on a past history of febrile seizures, one past unprovoked seizure, and the occurrence of incontinence during two of her amnestic episodes. All seven patients had had at least one normal EEG prior to establishment of the diagnosis (range, 1-4 normal EEGs). All patients were treated with carbamazapine and have remained free of amnestic spells with a mean follow-up of 18 months (range,5 months-3 years). CONCLUSIONS: Epilepsy of temporal lobe origin can present with clinical events similar to TGA. TEA should be suspected in any patient presenting with two or more episodes of amnesia. Multiple EEGs may be necessary in order to establish the diagnosis.