J Clin Neurol.  2023 Nov;19(6):530-538. 10.3988/jcn.2022.0368.

Clinical Course and Recurrence in Transient Global Amnesia: A Study From the TEMPiS Telestroke Network

• Taheri S
• Peters N
• Zietz A
• Abel B
• Hubert G
• Barinka F
• Wiestler H
• Kovacic I
• Linker R
• Schlachetzki F
• Backhaus R

• KMID: 2547213
• DOI: http://doi.org/10.3988/jcn.2022.0368

Abstract

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.

Keyword

transient global amnesia; arterial hypertension; recurrent TGA; trigger factors; telemedical stroke network