Montage of abnormal brain FDG-PET scans in a case series of transient epileptic amnesia. FDG-PET may also complement MRI in distinguishing TEA from neurodegenerative disease when suspected.Īmnestic spells dementia memory impairment neurodegenerative disease sleep electroencephalogram (EEG). In the appropriate clinical context, our findings support the use of early prolonged EEG with emphasis on sleep monitoring as a key diagnostic tool. This syndrome is frequently associated with persistent interictal cognitive/behavioral symptoms and thus can be mistaken for common mimics. Conclusions: TEA is a treatable cause of amnestic spells in older adults. Anti-seizure therapy, most often with a single agent, resulted in improvement (reduction in spell frequency and/or subjective improvement in interictal cognitive/behavioral complaints) in all 17 cases with available follow-up. FDG-PET identified focal hypometabolism in 2/8 cases where it was performed, both involving the frontal and/or temporal regions. Brain MRI revealed focal abnormalities in only 4/19 cases (21%). In numerous cases, sleep and prolonged EEG evaluations identified abnormalities not previously seen on shorter or awake-state studies. EEG revealed epileptiform abnormalities involving the frontal and/or temporal regions in 12/19 individuals (63%), including activation during sleep in all of these cases. Thirteen patients (68%) reported persistent cognitive/behavioral symptoms, including 4 (21%) for whom these were the chief presenting complaints. Results: Nineteen patients were identified (14 men, 5 women) with median onset age 66 years and median time to diagnosis 2 years. Diagnostic criteria included the presence of recurrent episodes of transient amnesia with preservation of other cognitive functions and evidence for epilepsy. Methods: We performed a retrospective analysis of patients diagnosed with TEA at the Mayo Clinic Minnesota from Januto September 21, 2017. Response to antiepileptic drugs is less evident.Įpileptic pseudodementia memory disturbances temporal lobe epilepsy transient epileptic amnesia.Objective: To characterize the clinical, EEG, and neuroimaging profiles of transient epileptic amnesia (TEA). It is due to very frequent and recurrent subtle temporal lobe seizures. Epileptic pseudodementia is a pure disturbance of verbal episodic memory, stable over time. Interictal memory disturbances consist of autobiographic memory disorders and long term forgetting. Conversely to TGA, TEA have a shorter duration, is recurrent but have a clear-cut response to antiepileptic drugs. The main differential diagnosis is transient global amnesia (TGA). TEA is characterized by recurrent episodes of acute transient amnesia lasting less than one hour. Transient epileptic amnesia (TEA) is a subtype of medial temporal lobe epilepsy with late onset. Both represent potentially reversible memory disturbances and have a treatment based on antiepileptic drugs. Two atypical clinical epileptic syndromes should be pointed out in the elderly: the transient epileptic amnesia and the epileptic pseudodementia. ictal memory disturbances, or between seizures, i.e. These memory disturbances may occur during seizures, i.e. The epileptic syndromes, notably the temporal lobe epilepsy, frequently include memory disturbances.
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