Routine physical and neurological examination revealed no abnormalities. The patient remembered these amnesic episodes and what she did during those events. One month later, when the patient exited the subway train, she lost her way for about 10 minutes. During these attacks, cognitive functions other than memory seemed to remain intact. The amnesia lasted for about thirty minutes. Specifically, the patient repeatedly asked about what she did last night. Her husband noticed that the patient suffered from retrograde amnesia upon waking. He has been free of memory disturbances for 3 months.Ī 63-year-old right-handed woman was admitted for evaluation of recurrent and brief memory disturbances. The patient was treated with 15 mg/kg of carbamazepine controlled-release (CR), followed by maintenance dose of 200 mg twice per day. Routine blood tests, including blood cell counts, routine chemistry tests, and tests to determine the levels of ammonia and creatine phosphokinase revealed no significant abnormalities. Brain single-photon emission computed tomography revealed no significant increase or decrease of perfusion in the temporal lobes. On electroencephalographic (EEG), epileptiform discharges were observed in the right temporal leads, including F8 and T2 ( Fig. Magnetic resonance imaging (MRI) and MR angiography revealed no abnormalities in the hippocampi or other structures related to memory. The patient had a score of 29 on the Korean version of the mini-mental examination (K-MMSE) (2 out of 3 on memory recall test, could recall the other when cued). The patient was alert, fluent, and not disoriented to place or person. During the above episodes, the patient’s family did not observe any other cognitive dysfunction other than amnesia. After these episodes, however, the patient remembered what happened during those events. The patient’s memories gradually returned over a period of 20 minutes. He continued to ask when the nephew was married and why he was married so early. The patient did not remember his nephew’s wedding, which had taken place 4 days prior. Similar symptoms were observed again on the next day. The symptoms lasted for about 10 minutes and then disappeared. He could not remember his job and kept asking why he had to go to work despite his wife’s repeated explanations. Two days before admission, the patient experienced an episode of transient amnesia that began abruptly during breakfast. The patient had no other notable past medical or psychiatric disease. We will then discuss the mechanisms underlying our observations.Ī 77-year-old right-handed man was admitted to our department with recurrent episodes of transient amnesia. These episodes were caused by non-dominant temporal lobe epilepsy. They were amnesic during the episodes, but remembered the events after the episodes. Here we report the cases of two patients with TEA who presented with amnesia with preserved consciousness. Although TEA is distinguished from TGA by a relatively brief duration (less than an hour), high frequency of episodes, common occurrence upon waking, patients with TEA generally cannot remember the amnestic episodes. TEA closely resembles TGA because transient amnesia is sometimes the sole manifestation of the seizures. 1, 2 Transient epileptic amnesia (TEA) is a sub-type of mesial temporal lobe epilepsy characterized by recurrent episodes of transient memory disturbances. TGA usually lasts for a few hours and is accompanied by typical behavioral changes. The most common cause of transient amnesia is transient global amnesia (TGA), which is characterized by the abrupt onset of anterograde amnesia without disturbances in other cognitive functions. Transient amnesia is a commonly encountered clinical manifestation with diverse causes.
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