Shedding light on the clinical recognition process of transient global amnesia
Background and purpose Diagnostic uncertainty is common in the emergency evaluation of neurological conditions such as acute confusional states, particularly for non‐neurologists. We aimed to investigate the clinical recognition process of transient global amnesia (TGA) before arrival at the hospita...
Saved in:
| Published in: | European journal of neurology Vol. 27; no. 10; pp. 1821 - 1824 |
|---|---|
| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
John Wiley & Sons, Inc
01-10-2020
|
| Subjects: | |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Background and purpose
Diagnostic uncertainty is common in the emergency evaluation of neurological conditions such as acute confusional states, particularly for non‐neurologists. We aimed to investigate the clinical recognition process of transient global amnesia (TGA) before arrival at the hospital and in the emergency department (ED).
Methods
In this retrospective observational study, medical records of 365 patients with TGA were analysed concerning mode of arrival, symptoms and suspected diagnosis made by pre‐hospital medical care providers and the ED neurologist.
Results
More than half of the 248 patients who were evaluated before arrival at the hospital (N = 157, 63.3%) received a diagnosis of suspected stroke, whereas TGA was considered in only 16 patients (6.5%), with recognition of acute amnesia in 150 patients (60.5%) and disturbed orientation in 86 patients (34.7%). Repetitive questions by the patient were noted in 28 patients (11.3%). In contrast, in 355 patients (97.3%), TGA was considered the primary diagnosis by the ED neurologist. Diagnosis in the ED was achieved by documenting ongoing impairment of episodic verbal memory (100.0%), repetitive questions as a prominent ancillary finding (95.5%) and the lack of focal neurological symptoms (100.0%) or by carefully obtaining collateral history suggestive of anterograde memory disturbance (89.9%) and/or repetitive questions (85.7%).
Conclusion
Recognizing TGA crucially depends on identifying isolated anterograde episodic long‐term memory disturbance or its observable effects such as repetitive questions and actions. |
|---|---|
| Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 |
| ISSN: | 1351-5101 1468-1331 |
| DOI: | 10.1111/ene.14371 |