![]() ![]() She was heterozygous for the C677T and the A1298C mutations in the methylenetetrahydrofolate reductase (MTHFR) gene. Blood test, including thyroid function evaluation, coagulative and autoimmune screening, were within the normal range. At the evaluation, she complained of easy irritability, difficulty to gain weight, feeling of pounding, flushing with profuse sweating, and a feeling of “internal tremor.” Neurological examination was normal. ![]() Thus, she was prescribed low weight heparin, and submitted to a neurological assessment. Such episode lasted about 2 hours, and was followed by headache, without memory about it. Twenty-four hours before medical consult, she started to become repetitive, asking the same questions, mainly concerning the memory loss itself. The patient was a strong smoker since adolescence (about 40 cigarettes /daily). Family history was positive for cardiovascular and cerebrovascular diseases (her father died at 51 years due to an ischemic cardiac attack her mother suffered from high blood pressure and cerebrovascular disease) and for inflammatory autoimmune diseases (sister affected by psoriatic arthritis). The patient was a 40 year-old woman, born from nonconsanguineous parents. ![]() Herein, we report 3 young patients presenting TGA, ascribed to different conditions and neuroradiological presentation. TGA usually occurs during the seventh decade of life (mean age: 61–67.3 years), that is, when risk factors and concomitant pathologies have a higher incidence, with a peak observed around the age of 62, and it is more frequent in females. Diagnostic criteria for this clinical syndrome were carried out in 1990 by Hodges and Warlow: that is, attacks must be witnessed presence of anterograde amnesia during the attack cognitive impairment is limited to amnesia no clouding of consciousness or loss of personal identity no focal neurological signs/symptoms no epileptic features attack must resolve within 24 hours no recent head injury or active epilepsy. TGA was described for the first ever time in 1964 by Fisher and Adams, who reported on 17 patients with sudden onset anterograde amnesia and confusion that resolved within a few hours. The main risk factors for TGA are considered migraine history, cardiovascular risk factors, that is, ischemic heart disease, carotid atheromasia, and psychophysical stress. The presence of mild subclinical neuropsychological deficits and vegetative symptoms may also occur, and they can last for days after the episode. Transient global amnesia (TGA) is characterized by a sudden onset of an anterograde and retrograde amnesia, often associated with executive function and recognition impairment, lasting up to 24 hours and not otherwise associated with other neurological deficits. The occurrence of different precipitating events and accurate questioning (in the absence of head trauma) seem to be key features in making the diagnosis of TGA, besides a complete neuropsychiatric and cardiovascular assessment. TGA completely recovery within 1 to 7 days. The patients underwent neuroimaging and cardiovascular examination, and neuropsychological evaluation, without important abnormalities. We report 3 cases of TGA triggered by different causes (cardiovascular risk factors, emotional stress, and orgasm) with an unusual young onset (patient 1 was a 40-year-old woman, patient 2 was a 21-year-old woman, and patient 3 a 32-year-old man). TGA usually occurs during the seventh decade of life, that is, when risk factors and concomitant pathologies have a higher incidence. Migraine history, cardiovascular risk factors, and emotional stress are considered possible risk factors. Transient global amnesia (TGA) is characterized by a sudden onset of anterograde and retrograde amnesia, sometimes associated with mild subclinical neuropsychological deficits and vegetative symptoms, lasting for days after the episode. The work cannot be used commercially without permission from the journal. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The authors have no conflicts of interest to disclose. Patients gave their informed consent for data acquisition and publication. ![]() ∗Correspondence: Rocco Salvatore Calabrò, IRCCS Centro Neurolesi “Bonino Pulejo,” Cda Casazza, 98123, Messina, Italy (e-mail:, ).Ībbreviations: MMPI = Minnesota Multiphasic Personality Inventory, MRI = magnetic resonance imaging, MTHFR = methylenetetrahydrofolate reductase, SCID = structured clinical interview for DSM-IV, TEA = transient epileptic amnesia, TGA = transient global amnesia, TIA = transient ischemic attack. IRCCS Centro Neurolesi “Bonino Pulejo,” Messina, Italy. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |