title: Transient memory impairment and transient global amnesia induced by photodynamic therapy.
abstract: Photodynamic therapy (PDT) is a commonly used and effective treatment option for nonmelanoma skin cancer. Apart from local side-effects such as pain, oedema and erythema, no major adverse events occur in the majority of cases. Here we report on five patients who developed memory deficits such as transient global amnesia immediately after PDT for actinic keratosis. All PDT treatments were performed according to standard therapy protocols. The reported patients had a memory gap for the entire procedure, as well as for the consecutive emergency medical care. Other common neurological causes such as stroke or epileptic seizures were excluded. No focal neurological deficits were detectable. The symptoms had a fairly rapid onset following red-light illumination and were reversible without sequelae within 1-24 h. No correlation of the condition and pain during the illumination could be revealed. Magnetic resonance imaging of the brain revealed punctuated lesions in the hippocampus as a potential morphological correlate in one patient. The association between amnestic syndromes and PDT is novel and has not previously been reported. Even though PDT is considered a safe treatment modality, the possibility of neurological adverse events, albeit rare, should be kept in mind.
authors.affiliation: Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany.
authors.forename: M
authors.identifier: http://orcid.org/0000-0002-0465-3506
authors.initials: M
authors.lastname: Reinholz
authors.affiliation: Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany.
authors.forename: M V
authors.initials: MV
authors.lastname: Heppt
authors.affiliation: Institute of Clinical Neuroimmunology, Ludwig Maximilian University, Munich, Germany.
authors.forename: F S
authors.initials: FS
authors.lastname: Hoffmann
authors.affiliation: Department of Nuclear Medicine, Ludwig Maximilian University, Munich, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Lummel
authors.affiliation: Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Ruzicka
authors.affiliation: Department of Dermatology, Allergy, and Surgical Dermatology, HELIOS Klinikum Wuppertal, University of Witten-Herdecke, Wuppertal, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Lehmann
authors.affiliation: Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Berking
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000009:adverse effects*; D020236:Amnesia, Transient Global / Q000139:chemically induced*; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000009:adverse effects*
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid