Conference Coverage

Transient epileptic amnesia: Rare, treatable, and easy to miss

 

Key clinical point: Transient epileptic amnesia, while rare, can be revealed with imaging and treated with antiepileptic drugs.

Major finding: Brain FDG-PET revealed focal abnormalities in 69% of subjects with suspected TEA.

Study details: A retrospective analysis of 31 suspected TEA cases treated from 1998-2017 at one clinic.

Disclosures: Dr. Ramanan and his colleagues disclosed no conflicts of interest.

Source: Ramanan V et al. Neurology. 2018 Apr 90(15 Suppl.):P3.035.


 

REPORTING FROM AAN 2018

– Transient epileptic amnesia is a rare but a treatable memory condition that usually occurs in late life and can be mistaken for neurodegenerative disease among patients presenting to a neurology or memory clinic.

Transient epileptic amnesia (TEA) is thought to be a focal epilepsy whose major clinical feature is the presence of recurrent spells of anterograde or retrograde amnesia lasting under an hour. The spells tend to occur on waking from sleep.

A woman rests her head in her hand. ©Thinkstock
Patients do not usually show prominent deficits in other cognitive domains, and the disorder can come with more chronic memory complaints between spells, with patients reporting accelerated forgetting over days to weeks of recently learned information, or patchy losses of remote autobiographical memory.

At the annual meeting of the American Academy of Neurology, Vijay Ramanan, MD, PhD, of the Mayo Clinic in Rochester, Minn., presented a retrospective series of 31 TEA cases from a study attempting to characterize the disorder in more demographic, clinical, and neuroimaging detail than has been done in the literature to date.

The cases were seen over a 20-year period (1998-2017) at the Mayo Clinic. All had at least one EEG and at least one MRI result reviewed by a neuroradiologist. Half also underwent fluorodeoxyglucose (FDG)-positron emission tomography (PET). All cases were classed as TEA if they included recurrent amnesia and an epileptic trait (lip smacking, for example), recurrent amnesiac spells and memory complaints between spells, or memory complaints and an epileptic trait.

Of the 31 cases, two-thirds were male, and the mean age was 70. Neuropsychological testing found mild nonspecific abnormalities in 10 individuals and mild cognitive impairment in 2.

The investigators found 20 patients had abnormalities on EEG, usually in the temporal epileptogenic region. On MRI, abnormalities were found in only 6 patients.

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