![]() Also, there are no indications that TGA represents a risk factor for cerebral ischemia. To date, there is no evidence for the presence of chronic sequelae with respect to chronic memory impairment or the development of dementia-related syndromes. Possible cerebrovascular risk factors should be identified and treated according to guidelines. Inpatient monitoring can be considered for at least 24 h or until symptoms resolve, especially if there is no possibility of supervision by relatives.īecause the pathomechanism of TGA is not yet clearly known, no evidence-based recommendations can be made regarding prophylaxis. ![]() Absence of EEG abnormalities does not necessarily rule out an epileptic etiology. TGA is a disorder that occurs predominantly between the ages of 50 and 70 years TGA in patients 3/year). ![]() If additional DWI changes are outside the hippocampus, a vascular etiology should be considered, and prompt sonographic and cardiac diagnostics should be performed. The sensitivity of MRI is considered higher when performed between 24 and 72 h after onset.Ĭranial MRI also helps to exclude other causes of the amnestic episodes, especially ischemic stroke If the presentation is atypical, immediate imaging is indicated. The diagnosis of TGA can be positively supported by MR imaging: The detection of typical unilateral or bilateral punctate DWI/T2 lesions in the hippocampus (especially the CA1 region) in a proportion of patients proves TGA. In case of an atypical clinical presentation or suspicion of a possible differential diagnosis, further diagnostics (imaging, preferably MRI, if necessary, EEG, laboratory, or CSF diagnostics) should be performed immediately. The diagnosis of TGA should be made clinically. A complete version of this guideline (in German) can be found on the website of the Deutsche Gesellschaft für Neurologie ( and the AWMF (Arbeitsgemeinschaft wissenschaftlicher Medizinischer Fachgesellschaften). This guideline is a translated version of the german guideline “Transiente globale Amnesie”. Since the pathomechanism of TGA has not yet been definitively clarified, a multifactorial or multi-causal process seems likely, As empirical data are also lacking, no sufficiently evidence-based recommendations can be made regarding prophylaxis. In general, the prognosis of a TGA is very favorable. The diagnosis usually can be established in the acute stage based on the criteria of Caplan and Hodges and Warlow. The diagnosis of TGA is based on the patient’s history and that of others, as well as on clinical neurological and orienting neuropsychological examination, in particular the exclusion of possible differential diagnoses. Transient global amnesia (TGA) is characterized by a sudden onset of retrograde and anterograde amnesia for a period of one to a maximum of 24 h with an incidence between 3 and 8 per 100,000 population per year. There is no evidence for chronic sequelae of TGA with respect to cerebral ischemia, chronic memory impairment, or the onset of dementia-related syndromes. Because the pathomechanism of TGA is not yet clearly known, no evidence-based therapeutic or prophylactic recommendations can be made. Numerous findings in recent years point to a multifactorial genesis. TGA in patients < 50 years of age is a rarity, therefore it is mandatory to rapidly search for other causes in particular in younger patients. If additional DWI changes occur outside the hippocampus, a vascular etiology should be considered, and prompt sonographic and cardiac diagnostics should be performed EEG may help to differentiate TGA from rare amnestic epileptic attacks, especially in recurrent amnestic attacks. The sensitivity of MRI is considered higher when performed between 24 and 72 h after onset. The detection of typical unilateral or bilateral punctate DWI/T2 lesions in the hippocampus (especially the CA1 region) in a proportion of patients proves TGA. In case of an atypical clinical presentation or suspicion of a possible differential diagnosis, further diagnostics should be performed immediately. TGA is a disorder that occurs predominantly between 50 and 70 years. The incidence is estimated between 3 and 8 per 100,000 population/year. TGA is characterized by a sudden onset of retrograde and anterograde amnesia for a period of one to a maximum of 24 h (with an average of 6 to 8 h). In 2022 the DGN (Deutsche Gesellschaft für Neurologie) published an updated Transient Global Amnesia (TGA) guideline.
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