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KMID : 1130620230190060530
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Journal of Clinical Neurology
2023 Volume.19 No. 6 p.530 ~ p.538
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Clinical Course and Recurrence in Transient Global Amnesia: A Study From the TEMPiS Telestroke Network
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Shadi Taheri
Nils Peters
Annaelle Zietz
Berthold Abel
Gordian Hubert
Filip Barinka
Hanni Wiestler
Irena Kovacic
Ralf Linker
Felix Schlachetzki
Roland Backhaus
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Abstract
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Background and Purpose : While the clinical hallmarks of transient global amnesia (TGA) are well defined, its pathophysiological causes are poorly understood. Specifically, risk factors for recurrences are yet to be determined.
Methods : This retrospective study analyzed TGA cases diagnosed and treated within the TEMPiS telestroke network and a university stroke center in Germany. Demographic and clinical data were assessed and characteristics of TGA episodes were recorded, such as season of occurrence, trigger factors, duration, and concomitant symptoms. Follow-up of the potential recurrence of TGA was performed using a standardized questionnaire.
Results : Overall 109 patients were included (age 64±8 years [mean±SD], 59.6% female). The most common vascular risk factor was arterial hypertension (60.6%), and other concomitant conditions included migraine (11.9%), hypothyroidism (22.9%), and atrial fibrillation (4.6%). The most frequent concomitant clinical feature accompanying the TGA episode at admission was elevated blood pressure (48.6%). Nineteen patients experienced at least one recurrent TGA episode. Migraine and hypothyroidism were only observed in subjects with a single TGA episode without recurrence (migraine: 14.4% without recurrence vs. none in the recurrence group, p=0.02; hypothyroidism: 27.8% without recurrence vs. none in the recurrence group, p=0.009). In contrast, atrial fibrillation was more common in subjects with TGA recurrence (p<0.001).
Conclusions : Arterial hypertension is prevalent in TGA patients, with elevated blood pressure being the most-frequent concomitant condition. In our cohort, recurrence of TGA occurred in approximately one-fifth of patients. Concomitant conditions such as migraine, hypothyroidism, and atrial fibrillation occurred at different frequencies in the two groups.
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KEYWORD
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transient global amnesia, arterial hypertension, recurrent TGA, trigger factors, telemedical stroke network
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