title: An increased frequency of patent foramen ovale in patients with transient global amnesia. Analysis of 53 consecutive patients.
abstract: OBJECTIVE
  Alerted by the number of patients with transient global amnesia (TGA) in whom Valsalvalike activities immediately preceded the onset of TGA, we have investigated the frequency of patent foramen ovale (PFO) as the prerequisite for paradoxical embolism.
  
  
  METHODS
  Case series with comparison to a control group.
  
  
  METHODS
  Hospitalized and ambulatory patients at the neurological departments of the Alfried Krupp Hospital, Essen, Germany, and the Rheinisch-Westfälische-Technische Hochschule, Aachen, Germany.
  
  
  METHODS
  Fifty-three consecutive patients with TGA were evaluated by the 2 centers between 1988 and 1995.
  
  
  RESULTS
  Using contrast transcranial Doppler sonography we have observed a PFO in 55% of the patients with TGA, compared with 27% of a control group of 100 patients. This difference was statistically significant (P < .01). Twenty-five patients with TGA (47%), 15 of them with a proven PFO, reported a precipitating activity, such as the lifting of heavy weights, immediately before the TGA occurred.
  
  
  CONCLUSIONS
  In addition to other pathological mechanisms, paradoxical embolism with temporobasal ischemia could possibly play a role in the clinical syndrome of TGA. This hypothesis could explain the frequent observation of preceding Valsalvalike activities in patients with TGA.
authors.affiliation: Department of Neurology, Alfried Krupp Hospital, Essen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Klötzsch
authors.forename: U
authors.initials: U
authors.lastname: Sliwka
authors.forename: P
authors.initials: P
authors.lastname: Berlit
authors.forename: J
authors.initials: J
authors.lastname: Noth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000647:Amnesia / Q000000981:diagnostic imaging / Q000209:etiology*; D001143:Arousal / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion / Q000502:physiology; D012307:Risk Factors; D017585:Ultrasonography, Doppler, Transcranial; D014636:Valsalva Maneuver / Q000502:physiology