Lesson of the month 2: Transient reversible amnesia in multiple sclerosis.
Transient amnestic syndromes are fascinating clinical entities and there are several subtypes. Transient global amnesia (TGA) is characterised by sudden onset of anterograde amnesia with repetitive questioning, lasting less than 24 hours. The pathophysiology of TGA involves the medial temporal lobes and hippocampi. Episodes of TGA are thought to involve venous congestion with Valsalva-like activities, vascular or migrainous mechanisms. In contrast, transient epileptic amnesia manifests as brief and frequent episodes of amnesia due to seizure activity in the temporal lobes. Transient memory disturbances can also be caused by transient ischaemic attack. We describe the first reported case of transient reversible amnesia directly attributable to acute demyelination. This case reminds us that multiple sclerosis relapses may present with acute cognitive impairment rather than the more classical physical symptoms. This is an important learning point in terms of appropriate management and eligibility for disease-modifying drugs.
Department of Neurology, Leeds Centre for Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Priya Devi
PD
Shanmugarajah
Department of Neurology, Leeds Centre for Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Jane
J
Alty
Department of Neurology, Leeds Centre for Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Oliver
O
Lily
Department of Neurology, Leeds Centre for Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Helen L
HL
Ford
D000328:Adult; D020236:Amnesia, Transient Global; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications* / Q000000981:diagnostic imaging
Anterograde amnesia; demyelinating disorders; multiple sclerosis; temporal lobe