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Albrecht P, Berteld C, Neukäter W. [The sex was to forget : The case of an acute postcoital confusional state]. Med Klin Intensivmed Notfmed 2024; 119:63-65. [PMID: 37853255 DOI: 10.1007/s00063-023-01073-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/09/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023]
Affiliation(s)
- P Albrecht
- Abteilung für Neurologie, Evangelisches Krankenhaus Wesel, Schermbecker Landstr. 88, 46485, Wesel, Deutschland.
| | - C Berteld
- Abteilung für Neurologie, Evangelisches Krankenhaus Wesel, Schermbecker Landstr. 88, 46485, Wesel, Deutschland
| | - W Neukäter
- Abteilung für Neurologie, Evangelisches Krankenhaus Wesel, Schermbecker Landstr. 88, 46485, Wesel, Deutschland
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Cretin B, Philippi N, Bousiges O, Blanc F. Transient epileptic amnesia: a retrospective cohort study of 127 cases, including CSF amyloid and tau features. J Neurol 2023; 270:2256-2270. [PMID: 36715748 DOI: 10.1007/s00415-023-11576-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND Transient epileptic amnesia (TEA) is a late-onset epilepsy syndrome encompassing transient iterative amnesias and interictal cognitive impairment, two features that overlap with incipient neurodegenerative dementias. We, therefore, examined the yield of CSF amyloid and tau biomarkers in TEA. METHODS In this retrospective study, 127 TEA patients with unremarkable imaging findings were divided into 2 groups, namely, CSF (n = 71) and no-CSF (n = 56). Both were compared for demographics; medical history; baseline neurological, cognitive, and behavioral features; baseline mesial temporal lobe atrophy; and cognitive follow-up at a median of 13 months. CSF samples were examined for amyloid β-42 peptide as well as phospho-tau and total-tau levels. RESULTS At baseline, the CSF-TEA group had significantly (p < 0.01) more frequent mild parkinsonism (42.9% vs. 20%) and cognitive concerns (31% vs. 10.7%), a more blunted sense of smell (34.3% vs. 9.4%), a lower baseline MMSE score (27 vs. 28.9), a more frequent amnestic mild cognitive impairment profile (69% vs. 42.6%), and more atrophic hippocampal changes. At follow-up, the CSF-TEA group had significantly (p < 0.01) lower MMSE scores (27.8 vs. 28.9). CSF analyses revealed amyloid and/or tau changes in 27 patients (38%), including an Alzheimer's disease (AD) profile in 17 (24%). CONCLUSIONS This study shows a good diagnostic value of CSF sampling in a specific population of TEA with characteristics suggestive of incipient degenerative diseases (i.e., red flags). It argues for TEA being the inaugurating feature in some cases of AD. More broadly, our results suggest an etiological heterogeneity in TEA.
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Affiliation(s)
- Benjamin Cretin
- Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), Service de Neurologie des Hôpitaux Universitaires de Strasbourg, Pôle Tête et Cou, 1 Avenue Molière, 67200, Strasbourg, France.
- Unité de Neuropsychologie, Service de Neurologie et hôpital de jour de Gériatrie, pôle de Gériatrie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), Team IMIS/Neurocrypto Strasbourg, Strasbourg, France.
- Centre de Compétences des démences rares des Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
| | - Nathalie Philippi
- Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), Service de Neurologie des Hôpitaux Universitaires de Strasbourg, Pôle Tête et Cou, 1 Avenue Molière, 67200, Strasbourg, France
- Unité de Neuropsychologie, Service de Neurologie et hôpital de jour de Gériatrie, pôle de Gériatrie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), Team IMIS/Neurocrypto Strasbourg, Strasbourg, France
- Centre de Compétences des démences rares des Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Olivier Bousiges
- Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), Service de Neurologie des Hôpitaux Universitaires de Strasbourg, Pôle Tête et Cou, 1 Avenue Molière, 67200, Strasbourg, France
- University Hospital of Strasbourg, Laboratory of Biochemistry and Molecular Biology, CNRS, Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA), UMR7364, Strasbourg, France
| | - Frédéric Blanc
- Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), Service de Neurologie des Hôpitaux Universitaires de Strasbourg, Pôle Tête et Cou, 1 Avenue Molière, 67200, Strasbourg, France
- Unité de Neuropsychologie, Service de Neurologie et hôpital de jour de Gériatrie, pôle de Gériatrie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), Team IMIS/Neurocrypto Strasbourg, Strasbourg, France
- Centre de Compétences des démences rares des Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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Uehara T, Akamatsu N, Tomura M, Yamashita C, Taira A, Suezumi K, Murai H. Waking amnesia as a postictal symptom after seizure-induced arousal in a patient with transient epileptic amnesia: An ictal video-electroencephalogram finding. Seizure 2022; 100:21-23. [PMID: 35724522 DOI: 10.1016/j.seizure.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 10/18/2022] Open
Affiliation(s)
- Taira Uehara
- Department of Neurology, International University of Health and Welfare, Narita Hospital, Narita, Japan.
| | - Naoki Akamatsu
- Department of Neurology, International University of Health and Welfare, Narita Hospital, Narita, Japan
| | - Masaki Tomura
- Department of Neurology, International University of Health and Welfare, Narita Hospital, Narita, Japan
| | - Chikara Yamashita
- Department of Neurology, International University of Health and Welfare, Narita Hospital, Narita, Japan
| | - Akihiko Taira
- Department of Neurology, International University of Health and Welfare, Narita Hospital, Narita, Japan
| | - Koki Suezumi
- Department of Neurology, International University of Health and Welfare, Narita Hospital, Narita, Japan
| | - Hiroyuki Murai
- Department of Neurology, International University of Health and Welfare, Narita Hospital, Narita, Japan
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Schlemm E, Magnus T, Rimmele LD, Münsterberg J, Bester M, Kessner SS, Gelderblom M, Gerloff C. Recurrent amnesia caused by early seizures after hippocampal infarction: a case report. BMC Neurol 2022; 22:18. [PMID: 35012472 PMCID: PMC8744318 DOI: 10.1186/s12883-021-02543-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background We report the case of a patient with recurrent episodes of disturbed memory suggestive of transient epileptic amnesia, and a focal hippocampal lesion typically associated with transient global amnesia. We argue how careful consideration of clinical, electrophysiological and imaging findings can resolve this apparent contradiction and lead to a diagnosis of early symptomatic post-stroke seizures that links brain structure to function in a new, clinically relevant way. Case presentation A 70-year-old patient was identified in clinical practice in our tertiary care centre and was evaluated clinically as well as by repeated electroencephalography and magnetic resonance imaging. The presenting complaint were recurrent episodes of short-term memory disturbance which manifested as isolated anterograde amnesia on neurocognitive evaluation. EEG and MRI revealed predominantly right frontotemporal spikes and a punctate diffusion-restricted lesion in the left hippocampus, respectively. Both symptoms and EEG changes subsided under anticonvulsant treatment with levetiracetam. Conclusions Our report contributes to the current discussion of clinical challenges in the differential diagnosis of transient memory disturbance. It suggests that focal diffusion-restricted hippocampal lesions, as seen in TGA, might be ischemic and thus highlights the importance of considering post-stroke seizures as a possible cause of transient memory disturbance.
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Affiliation(s)
- Eckhard Schlemm
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Tim Magnus
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Leander D Rimmele
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Justine Münsterberg
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maxim Bester
- Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention, Zentrum für Radiologie und Endoskopie, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon S Kessner
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mathias Gelderblom
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Gerloff
- Klinik und Poliklinik für Neurologie, Kopf- und Neurozentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Blain A, Sellal F, Philippi N, Blanc F, Cretin B. Transient epileptic amnesia is significantly associated with discrete CA1-located hippocampal calcifications but not with atrophic changes on brain imaging. Epilepsy Res 2021; 176:106736. [PMID: 34403990 DOI: 10.1016/j.eplepsyres.2021.106736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/17/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The exact etiology of transient epileptic amnesia (TEA) is currently unknown. In older individuals, common neurodegenerative dementias and small-vessel diseases (SVDs) could be major contributors. We examined these hypotheses on the basis of imaging analysis. METHODS In total, 36 TEA patients were compared with 25 healthy controls for (1) cortical atrophic changes (in the mesial temporal, frontal, anterior temporal, and parietal regions) using four established MRI-based visual rating scales, and for (2) SVD evidence using two MRI-based visual rating scales (Fazekas and MARS scores). In 24 TEAs cases, there were also brain CT scans available that were compared with 57 controls for the presence of hippocampal calcifications (HCs). RESULTS We did not find significant differences in cortical atrophy between TEAs and controls, nor did we observe a different SVD brain load on MRI. However, TEAs were significantly associated (p < 0.01) with uni- or bilateral CA1-located HCs in half of the patients compared with the controls (less than 20 %). CONCLUSIONS This study argues in favor of a hippocampal-restricted SVD (as indicated by HCs) as one of the major etiologies of TEA, while neurodegenerative dementias are probably minor causes. It furthermore highlights the pivotal role of the CA1 hippocampal subfield in the pathophysiology of this syndrome.
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McGinty RN, Larner AJ. Transient epileptic amnesia and pathological tearfulness. Cortex 2021; 147:206-208. [PMID: 34148639 DOI: 10.1016/j.cortex.2021.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Ronan N McGinty
- Cognitive Function Clinic, Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom
| | - Andrew J Larner
- Cognitive Function Clinic, Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom.
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Morano A, Fanella M, Cerulli Irelli E, Barone FA, Fisco G, Orlando B, Albini M, Fattouch J, Manfredi M, Casciato S, Di Gennaro G, Giallonardo AT, Di Bonaventura C. Seizures in autoimmune encephalitis: Findings from an EEG pooled analysis. Seizure 2020; 83:160-168. [PMID: 33161244 DOI: 10.1016/j.seizure.2020.10.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/14/2020] [Accepted: 10/19/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Seizures are common in autoimmune encephalitis (AE), and an extensive work-up is required to exclude alternative etiologies. The aim of our study was to identify possible clinical/EEG peculiarities suggesting the immune-mediated origin of late-onset seizures. METHODS Thirty patients diagnosed with AE (19 men, median age 68 years, 18 seronegative) were included. Overall 212 video-electroencephalographic (EEG) and 31 24-h ambulatory EEG (AEEG) recordings were retrospectively reviewed. Posterior dominant rhythm, interictal epileptiform discharges (IEDs), clinical (CSs) and subclinical seizures (SCSs) were analyzed. RESULTS Six-hundred-nineteen ictal events were recorded in 19/30 subjects, mostly (568/619) during AE acute stage. Among ten patients with CSs other than faciobrachial dystonic seizures, 7 showed prominent autonomic and emotional manifestations. SCSs were detected in 11 subjects, mainly via AEEG (260/287 SCSs vs 150/332 CSs, p < 0.001). Eight patients presented seizures during hyperventilation. IEDs, documented in 21 cases, were bilateral in 14 and focal temporal in 13. Multiple ictal EEG patterns were detected in 9/19 patients, 6 of whom had both CSs and SCSs, bilateral asynchronous seizures and ictal activities arising from temporal and extra-temporal regions. No correlation was found between the lateralization of MRI alterations and that of EEG findings. CONCLUSION Our study confirms that adult-onset, high frequency focal seizures with prominent autonomic and emotional manifestations should be investigated for AE. Multiple ictal EEG patterns could represent a 'red flag', reflecting a widespread neuronal excitability related to the underlying immune-mediated process. Finally, our work enhances the crucial role of long-lasting EEG monitoring in revealing subclinical and relapsing seizures.
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Affiliation(s)
- Alessandra Morano
- Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - Martina Fanella
- Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy; Neurology Unit, "San Camillo de' Lellis" General Hospital, Rieti, Italy
| | - Emanuele Cerulli Irelli
- Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - Francesca A Barone
- Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - Giacomo Fisco
- Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - Biagio Orlando
- Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | | | - Jinane Fattouch
- Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - Mario Manfredi
- Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - Sara Casciato
- Epilepsy Surgery Unit, IRCCS "Neuromed", Pozzilli, IS, Italy
| | | | - Anna Teresa Giallonardo
- Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - Carlo Di Bonaventura
- Epilepsy Unit, Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.
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Alessandro L, Ricciardi M, Chaves H, Allegri RF. Acute amnestic syndromes. J Neurol Sci 2020; 413:116781. [PMID: 32203745 DOI: 10.1016/j.jns.2020.116781] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/09/2020] [Accepted: 03/16/2020] [Indexed: 11/22/2022]
Abstract
Acute amnestic syndromes are usually rare clinical events occurring in emergency situations. Etiological diagnosis can be challenging and underlying causes diverse. They can be transient and totally reversible, or accompanied by other neurological symptoms resulting in serious and irreversible brain damage. Pathophysiology of these syndromes mainly corresponds to structural or functional alteration of memory circuits, including those in the hippocampus. One of the most frequent forms is transient global amnesia (TGA), characterized by sudden onset of anterograde amnesia lasting less than 24 hours, in the absence of other neurological signs or symptoms. Another acute and transient memory disorder is transient epileptic amnesia (TEA), due to focal crisis activity. Stroke injuries occurring at strategic memory-related sites can also present as sudden episodes of amnesia. In addition to neurological etiologies, amnesia may be a symptom of a psychiatric disorder (dissociative amnesia). Traumatic brain injuries, autoimmune encephalitis and acute toxic metabolic disorders can also cause amnesia and should be included among the differential diagnoses. In this review, we summarize the most relevant clinical findings in acute amnestic syndromes, and discuss the different ancillary tests needed to establish a correct diagnosis and management as well the best treatment options. Relevant anatomical and pathophysiological aspects underlying these conditions will be also be presented.
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Atherton KE, Filippini N, Zeman AZJ, Nobre AC, Butler CR. Encoding-related brain activity and accelerated forgetting in transient epileptic amnesia. Cortex 2018; 110:127-140. [PMID: 29861041 PMCID: PMC6335262 DOI: 10.1016/j.cortex.2018.04.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 04/06/2018] [Accepted: 04/30/2018] [Indexed: 12/25/2022]
Abstract
The accelerated forgetting of newly learned information is common amongst patients with epilepsy and, in particular, in the syndrome of transient epileptic amnesia (TEA). However, the neural mechanisms underlying accelerated forgetting are poorly understood. It has been hypothesised that interictal epileptiform activity during longer retention intervals disrupts normally established memory traces. Here, we tested a distinct hypothesis-that accelerated forgetting relates to the abnormal encoding of memories. We studied a group of 15 patients with TEA together with matched, healthy control subjects. Despite normal performance on standard anterograde memory tasks, patients showed accelerated forgetting of a word list over one week. We used a subsequent memory paradigm to compare encoding-related brain activity in patients and controls. Participants studied a series of visually presented scenes whilst undergoing functional MRI scanning. Recognition memory for these scenes was then probed outside the scanner after delays of 45 min and of 4 days. Patients showed poorer memory for the scenes compared with controls. In the patients but not the controls, subsequently forgotten stimuli were associated with reduced hippocampal activation at encoding. Furthermore, patients demonstrated reduced deactivation of posteromedial cortex regions upon viewing subsequently remembered stimuli as compared to subsequently forgotten ones. These data suggest that abnormal encoding-related activity in key memory areas of the brain contributes to accelerated forgetting in TEA. We propose that abnormally encoded memory traces may be particularly vulnerable to interference from subsequently encountered material and hence be forgotten more rapidly. Our results shed light on the mechanisms underlying memory impairment in epilepsy, and offer support to the proposal that accelerated forgetting may be a useful marker of subtle dysfunction in memory-related brain systems.
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Affiliation(s)
- Kathryn E Atherton
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK; Department of Experimental Psychology and Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Nicola Filippini
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Adam Z J Zeman
- Cognitive & Behavioural Neurology, University of Exeter Medical School, Exeter, UK
| | - Anna C Nobre
- Department of Experimental Psychology and Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Christopher R Butler
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK.
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Contador I, Sánchez A, Kopelman MD, González de la Aleja J. Long-term forgetting in temporal lobe epilepsy: Is this phenomenon a norm? Epilepsy Behav 2017; 77:30-32. [PMID: 29080418 DOI: 10.1016/j.yebeh.2017.09.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/19/2017] [Accepted: 09/22/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This research investigated forgetting rates of patients with temporal lobe epilepsy (TLE) at brief and longer intervals. METHODS The sample is formed by 5 patients with TLE and 10 healthy individuals. One of the patients received the diagnosis of transient epileptic amnesia (TEA). All patients underwent a standardized clinical protocol for diagnosis including a comprehensive neuropsychological assessment. In addition, two experimental tasks were used to assess the forgetting rates at 4 intervals (30s, 10min, 1day, and 1week): a story task to evaluate verbal cued recall and a route task to assess visuospatial cued recall. RESULTS There were no significant differences between groups in forgetting rates. CONCLUSIONS These findings suggest that forgetting patterns in patients with TLE may be heterogeneous, and the presence of accelerated long-term forgetting is not universal.
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Affiliation(s)
- Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Science, University of Salamanca, Salamanca, Spain.
| | - Abraham Sánchez
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Science, University of Salamanca, Salamanca, Spain
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Savage S, Hoefeijzers S, Milton F, Streatfield C, Dewar M, Zeman A. The evolution of accelerated long-term forgetting: Evidence from the TIME study. Cortex 2019; 110:16-36. [PMID: 29122206 DOI: 10.1016/j.cortex.2017.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 08/10/2017] [Accepted: 09/09/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Accelerated long-term forgetting (ALF) occurs when newly learned information decays faster than normal over extended delays. It has been recognised most frequently in temporal lobe epilepsy, including Transient Epileptic Amnesia (TEA), but can also be drug-induced. Little is known about the evolution of ALF over time and its impacts upon other memory functions, such as autobiographical memory (ABM). Here we investigate the long-term outcome of ALF and ABM in a group of patients with TEA and a single case of baclofen-induced ALF. METHODS Study 1 involved a longitudinal follow-up of 14 patients with TEA over a 10-year period. Patients repeated a neuropsychological battery, three ALF measures (with free recall probed at 30-min and 1-week), and a modified Autobiographical Memory Interview (MAMI). Performance was compared with a group of healthy age-matched controls. In Study 2, patient CS, who previously experienced baclofen-induced ALF, was followed over 4 years, and re-tested now, 18 months after ceasing baclofen. CS repeated a neuropsychological battery, three ALF experimental tasks (each probed after 30 min and 1 week), and a modified autobiographical interview (AI). Her performance was compared with healthy age-matched controls. RESULTS On ALF measures, the TEA group performed significantly below controls, but when analysed individually, 4 of the 7 patients who originally showed ALF no longer did so. In two, this was accompanied by improvements in ABM for recent but not remote memory. Patient CS no longer demonstrated ALF on standard lab-based tests and now appeared to retain new episodic autobiographical events with a similar degree of episodic richness as controls. CONCLUSION Long-term follow up suggests that ALF can resolve, with improvements translating to recent ABM in some cases.
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Lemesle B, Planton M, Pagès B, Pariente J. Accelerated long-term forgetting and autobiographical memory disorders in temporal lobe epilepsy: One entity or two? Rev Neurol (Paris) 2017; 173:498-505. [PMID: 28843413 DOI: 10.1016/j.neurol.2017.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/28/2017] [Accepted: 07/04/2017] [Indexed: 11/16/2022]
Abstract
Temporal lobe epilepsy (TLE) is a type of epilepsy that often has a negative impact on patients' memory. Despite the importance of patients' complaints in this regard, the difficulties described by these patients are often not easy to demonstrate through a standard neuropsychological assessment. Accelerated long-term forgetting and autobiographical memory disorders are the two main memory impairments reported in the literature in patients with TLE. However, the methods used by different authors to evaluate long-term memory and autobiographical memory are heterogeneous. This heterogeneity can lead to differences in the observed results as well as how they are interpreted. Yet, despite the methodological differences, objectification of such memory deficits appears to be both specific and robust within this patient population. Analysis of the literature shows that accelerated long-term forgetting and autobiographical memory disorders share the same clinical characteristics. This leads to the assumption that they are, in fact, only one entity and that their evaluation may be done through a single procedure. Our proposal is to place this evaluation within the context of memory consolidation disorders. With such a perspective, evaluation of accelerated forgetting in autobiographical memory should consist of identifying a disorder in the formation and/or recovery of new memory traces.
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Affiliation(s)
- B Lemesle
- Department of neurology, Toulouse university hospital, place du Dr-Baylac, 31059 Toulouse cedex, France; Toulouse neuroimaging center, université de Toulouse, Inserm, UPS, place du Dr-Baylac, 31059 Toulouse cedex, France.
| | - M Planton
- Department of neurology, Toulouse university hospital, place du Dr-Baylac, 31059 Toulouse cedex, France; Toulouse neuroimaging center, université de Toulouse, Inserm, UPS, place du Dr-Baylac, 31059 Toulouse cedex, France
| | - B Pagès
- Department of neurology, Toulouse university hospital, place du Dr-Baylac, 31059 Toulouse cedex, France; Toulouse neuroimaging center, université de Toulouse, Inserm, UPS, place du Dr-Baylac, 31059 Toulouse cedex, France
| | - J Pariente
- Department of neurology, Toulouse university hospital, place du Dr-Baylac, 31059 Toulouse cedex, France; Toulouse neuroimaging center, université de Toulouse, Inserm, UPS, place du Dr-Baylac, 31059 Toulouse cedex, France
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Burkholder DB, Jones AL, Jones DT, Fabris RR, Britton JW, Lagerlund TD, So EL, Cascino GD, Worrell GA, Shin C, St Louis EK. Frequent sleep-related bitemporal focal seizures in transient epileptic amnesia syndrome: Evidence from ictal video-EEG. Epilepsia Open 2017; 2:255-259. [PMID: 29588954 PMCID: PMC5719851 DOI: 10.1002/epi4.12040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/07/2022] Open
Abstract
Two patients who shared similar presenting clinical features of anterograde and retrograde autobiographical amnesia typical of transient epileptic amnesia (TEA) underwent prolonged video electroencephalogram (VEEG) monitoring and were found to have sleep-activated epileptiform activity and frequent subclinical bitemporal seizures predominantly during sleep. Case 1 is a 59-year-old woman whose presenting complaint was memory impairment. Over 18 months, she had three distinct 8-h-long episodes of confusion and disorientation with persistent anterograde and retrograde autobiographical amnesia. VEEG recorded frequent interictal bitemporal sharp waves confined to sleep, and 14 subclinical seizures, also mostly during sleep. Case 2 is a 50-year-old woman with known focal epilepsy also presented with memory complaints. Over the course of 1 year, she had two discrete 2-h-long episodes of amnesia, with ongoing anterograde and retrograde autobiographical amnesia. VEEG recorded independent bitemporal sharp waves, and 14 subclinical seizures during sleep and drowsiness. Memory impairment improved in both patients with successful treatment of their seizures. Although the etiology of accelerated long-term forgetting (ALF) and remote memory impairment (RMI) in transient epileptic amnesia (TEA) is unknown, these cases suggest frequent sleep-related seizures may contribute, and they highlight the importance of video-EEG monitoring.
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Affiliation(s)
- David B Burkholder
- Mayo Clinic Comprehensive Epilepsy Program Mayo Clinic College of Medicine Rochester Minnesota U.S.A.,Department of Neurology Mayo Clinic College of Medicine Rochester Minnesota U.S.A
| | - Amy L Jones
- Mayo Clinic Comprehensive Epilepsy Program Mayo Clinic College of Medicine Rochester Minnesota U.S.A.,Department of Neurology Mayo Clinic College of Medicine Rochester Minnesota U.S.A
| | - David T Jones
- Department of Neurology Mayo Clinic College of Medicine Rochester Minnesota U.S.A
| | - Rachel R Fabris
- Mayo Clinic Comprehensive Epilepsy Program Mayo Clinic College of Medicine Rochester Minnesota U.S.A.,Department of Neurology Mayo Clinic College of Medicine Rochester Minnesota U.S.A.,Spectrum Health Medical Group Rockford Michigan U.S.A
| | - Jeffrey W Britton
- Mayo Clinic Comprehensive Epilepsy Program Mayo Clinic College of Medicine Rochester Minnesota U.S.A.,Department of Neurology Mayo Clinic College of Medicine Rochester Minnesota U.S.A
| | - Terrence D Lagerlund
- Mayo Clinic Comprehensive Epilepsy Program Mayo Clinic College of Medicine Rochester Minnesota U.S.A.,Department of Neurology Mayo Clinic College of Medicine Rochester Minnesota U.S.A
| | - Elson L So
- Mayo Clinic Comprehensive Epilepsy Program Mayo Clinic College of Medicine Rochester Minnesota U.S.A.,Department of Neurology Mayo Clinic College of Medicine Rochester Minnesota U.S.A
| | - Gregory D Cascino
- Mayo Clinic Comprehensive Epilepsy Program Mayo Clinic College of Medicine Rochester Minnesota U.S.A.,Department of Neurology Mayo Clinic College of Medicine Rochester Minnesota U.S.A
| | - Gregory A Worrell
- Mayo Clinic Comprehensive Epilepsy Program Mayo Clinic College of Medicine Rochester Minnesota U.S.A.,Department of Neurology Mayo Clinic College of Medicine Rochester Minnesota U.S.A
| | - Cheolsu Shin
- Mayo Clinic Comprehensive Epilepsy Program Mayo Clinic College of Medicine Rochester Minnesota U.S.A.,Department of Neurology Mayo Clinic College of Medicine Rochester Minnesota U.S.A
| | - Erik K St Louis
- Department of Neurology Mayo Clinic College of Medicine Rochester Minnesota U.S.A.,Mayo Center for Sleep Medicine Mayo Clinic College of Medicine Rochester Minnesota U.S.A.,Department of Medicine Mayo Clinic College of Medicine Rochester Minnesota U.S.A
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14
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Savage SA, Butler CR, Milton F, Han Y, Zeman AZ. On the nose: Olfactory disturbances in patients with transient epileptic amnesia. Epilepsy Behav 2017; 66:113-119. [PMID: 28038387 PMCID: PMC6197428 DOI: 10.1016/j.yebeh.2016.09.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/29/2016] [Accepted: 09/30/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE While olfactory hallucinations are relatively rare in epilepsy, a high prevalence (up to 42%) has been reported in one form - Transient Epileptic Amnesia (TEA). TEA is characterized by recurring amnestic seizures and is commonly associated with persistent interictal memory deficits. Despite reports of changes in smell, olfactory ability has not been objectively assessed in this group. The aim of this study was to measure olfactory ability in patients with TEA and explore whether olfactory symptoms relate to other clinical variables. METHODS Fifty-five participants with TEA were recruited from The Impairment of Memory in Epilepsy project database. The presence of olfactory symptoms was obtained via case notes and clinical interview. Participants completed questionnaires to evaluate their olfaction and memory function subjectively. Olfactory ability was measured using the University of Pennsylvania Smell Identification Test (UPSIT). TEA participants' performance was compared to 50 matched healthy control participants. A subset of TEA participants (n=26) also completed a battery of memory tests including standard neuropsychological measures, and assessment of accelerated long-term forgetting and autobiographical memory. RESULTS Olfactory hallucinations were reported in 55% of patients with TEA. A significant reduction in smell identification (UPSIT) was found between patients with TEA and healthy controls (p<0.001). Epilepsy variables, including history of olfactory hallucinations, were not predictive of olfactory ability. Patients reported ongoing memory difficulties and performed below normative values on objective tests. While no correlation was found between objective measures of memory and olfactory performance, subjective complaints of route finding difficulty was associated with UPSIT score. CONCLUSIONS Impairments in odor identification are common in patients with TEA and exceed changes that occur in normal aging. Olfactory hallucinations occurs in approximately half of patients with TEA, but do not always coincide with reduced sense of smell. Olfactory impairment and interictal memory problems both occur frequently in TEA but are not closely associated.
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Affiliation(s)
- Sharon A. Savage
- Cognitive & Behavioural Neurology, University of Exeter Medical School, College House, St Luke’s Campus, Exeter, EX1 2LU, UK,corresponding author:
| | - Christopher R. Butler
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, John Radcliffe Hospital, OX3 9DU, UK
| | - Fraser Milton
- Discipline of Psychology, University of Exeter, Washington Singer Laboratories, Exeter, EX4 4QG, UK
| | - Yang Han
- Health Statistics, University of Exeter Medical School, South Cloisters, St Luke’s Campus, Exeter, EX1 2LU, UK
| | - Adam Z. Zeman
- Cognitive & Behavioural Neurology, University of Exeter Medical School, College House, St Luke’s Campus, Exeter, EX1 2LU, UK
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15
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Atherton KE, Nobre AC, Lazar AS, Wulff K, Whittaker RG, Dhawan V, Lazar ZI, Zeman AZ, Butler CR. Slow wave sleep and accelerated forgetting. Cortex 2016; 84:80-89. [PMID: 27710778 PMCID: PMC5084685 DOI: 10.1016/j.cortex.2016.08.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 07/04/2016] [Accepted: 08/29/2016] [Indexed: 12/12/2022]
Abstract
We investigated whether the benefit of slow wave sleep (SWS) for memory consolidation typically observed in healthy individuals is disrupted in people with accelerated long-term forgetting (ALF) due to epilepsy. SWS is thought to play an active role in declarative memory in healthy individuals and, furthermore, electrographic epileptiform activity is often more prevalent during SWS than during wakefulness or other sleep stages. We studied the relationship between SWS and the benefit of sleep for memory retention using a word-pair associates task. In both the ALF and the healthy control groups, sleep conferred a memory benefit. However, the relationship between the amount of SWS and sleep-related memory benefits differed significantly between the groups. In healthy participants, the amount of SWS correlated positively with sleep-related memory benefits. In stark contrast, the more SWS, the smaller the sleep-related memory benefit in the ALF group. Therefore, contrary to its role in healthy people, SWS-associated brain activity appears to be deleterious for memory in patients with ALF.
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Affiliation(s)
- Kathryn E Atherton
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Anna C Nobre
- Oxford Centre for Human Brain Activity, University of Oxford, Oxford, UK
| | - Alpar S Lazar
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, UK
| | - Katharina Wulff
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - Vandana Dhawan
- Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Zsolt I Lazar
- Department of Physics, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Adam Z Zeman
- Cognitive and Behavioural Neurology, Peninsular Medical School, University of Exeter, UK
| | - Christopher R Butler
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
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16
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Milburn-McNulty P, Larner AJ. Transient global amnesia and brain tumour: chance concurrence or aetiological association? Case report and systematic literature review. Case Rep Neurol 2015; 7:18-25. [PMID: 25802501 PMCID: PMC4357686 DOI: 10.1159/000371840] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report a patient presenting with episodes of transient amnesia, some with features suggestive of transient global amnesia (TGA), and some more reminiscent of transient epileptic amnesia. Investigation with neuroimaging revealed an intrinsic lesion in the right amygdala, with features suggestive of low-grade neoplasia. We undertook a systematic review of the literature on TGA and brain tumour. Fewer than 20 cases were identified, some of which did not conform to the clinical diagnostic criteria for TGA. Hence, the concurrence of brain tumour and TGA is very rare and of doubtful aetiological relevance. In some brain tumour-associated cases, epilepsy may be masquerading as TGA.
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Affiliation(s)
- Phil Milburn-McNulty
- Cognitive Function Clinic, Walton Centre for Neurology and Neurosurgery, Liverpool, UK
| | - Andrew J Larner
- Cognitive Function Clinic, Walton Centre for Neurology and Neurosurgery, Liverpool, UK
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17
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Dewar M, Hoefeijzers S, Zeman A, Butler C, Della Sala S. Impaired picture recognition in transient epileptic amnesia. Epilepsy Behav 2015; 42:107-16. [PMID: 25506793 DOI: 10.1016/j.yebeh.2014.10.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 10/06/2014] [Accepted: 10/28/2014] [Indexed: 11/29/2022]
Abstract
Transient epileptic amnesia (TEA) is an epileptic syndrome characterized by recurrent, brief episodes of amnesia. Transient epileptic amnesia is often associated with the rapid decline in recall of new information over hours to days (accelerated long-term forgetting - 'ALF'). It remains unknown how recognition memory is affected in TEA over time. Here, we report a systematic study of picture recognition in patients with TEA over the course of one week. Sixteen patients with TEA and 16 matched controls were presented with 300 photos of everyday life scenes. Yes/no picture recognition was tested 5min, 2.5h, 7.5h, 24h, and 1week after picture presentation using a subset of target pictures as well as similar and different foils. Picture recognition was impaired in the patient group at all test times, including the 5-minute test, but it declined normally over the course of 1week. This impairment was associated predominantly with an increased false alarm rate, especially for similar foils. High performance on a control test indicates that this impairment was not associated with perceptual or discrimination deficits. Our findings suggest that, at least in some TEA patients with ALF in verbal recall, picture recognition does not decline more rapidly than in controls over 1week. However, our findings of an early picture recognition deficit suggest that new visual memories are impoverished after minutes in TEA. This could be the result of deficient encoding or impaired early consolidation. The early picture recognition deficit observed could reflect either the early stages of the process that leads to ALF or a separable deficit of anterograde memory in TEA. Lastly, our study suggests that at least some patients with TEA are prone to falsely recognizing new everyday visual information that they have not in fact seen previously. This deficit, alongside their ALF in free recall, likely affects everyday memory performance.
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Affiliation(s)
- Michaela Dewar
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, UK; Psychology, School of Life Sciences, Heriot-Watt University, Edinburgh, UK.
| | - Serge Hoefeijzers
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, UK
| | - Adam Zeman
- Cognitive and Behavioural Neurology, University of Exeter Medical School, Exeter, UK
| | - Christopher Butler
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Sergio Della Sala
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, Psychology, University of Edinburgh, Edinburgh, UK
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18
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Cretin B, Philippi N, Sellal F, Dibitonto L, Martin-Hunyadi C, Blanc F. Can the syndrome of transient epileptic amnesia be the first feature of Alzheimer's disease? Seizure 2014; 23:918-20. [PMID: 25123897 DOI: 10.1016/j.seizure.2014.07.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/03/2014] [Accepted: 07/10/2014] [Indexed: 10/25/2022] Open
Affiliation(s)
- Benjamin Cretin
- Unité de Neuropsychologie, Service de Neurologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), France; Laboratoire ICube, CNRS-Université de Strasbourg, France; Centre de Compétences des démences rares des Hôpitaux Universitaires de Strasbourg, France.
| | - Nathalie Philippi
- Unité de Neuropsychologie, Service de Neurologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), France; Laboratoire ICube, CNRS-Université de Strasbourg, France; Centre de Compétences des démences rares des Hôpitaux Universitaires de Strasbourg, France
| | - François Sellal
- Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), France; Service de Neurologie, Hospices Civils de Colmar, France
| | - Laure Dibitonto
- Unité de Neuropsychologie, Service de Neurologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), France; Laboratoire ICube, CNRS-Université de Strasbourg, France; Centre de Compétences des démences rares des Hôpitaux Universitaires de Strasbourg, France
| | | | - Frederic Blanc
- Unité de Neuropsychologie, Service de Neurologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), France; Laboratoire ICube, CNRS-Université de Strasbourg, France; Centre de Compétences des démences rares des Hôpitaux Universitaires de Strasbourg, France
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19
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Del Felice A, Broggio E, Valbusa V, Gambina G, Arcaro C, Manganotti P. Transient epileptic amnesia mistaken for mild cognitive impairment? A high-density EEG study. Epilepsy Behav 2014; 36:41-6. [PMID: 24857807 DOI: 10.1016/j.yebeh.2014.04.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 04/15/2014] [Accepted: 04/18/2014] [Indexed: 02/07/2023]
Abstract
Mild cognitive impairment (MCI) converts to Alzheimer's disease within a few years of diagnosis in up to 80% of patients. The identification among such a population of a rare form of epilepsy (transient epileptic amnesia [TEA]), characterized by mixed anterograde and retrograde amnesia with apparent preservation of other cognitive functions, excessively rapid decay of newly acquired memories, and loss of memories for salient personal events of the remote past, strongly affects prognosis and medical treatment. Our aim was to define the clinical utility of routine high-density electroencephalography (EEG) in patients with MCI for the detection of epilepsy, especially TEA. Using high-density EEG (256 channels), we were able to single out 3 cases of TEA previously misdiagnosed as MCI in this cohort of 76 consecutive patients with MCI diagnosed at our center. Antiepileptic treatment effectively stopped the acute episodes of memory loss. To our knowledge, this is the first report of an incidence of 4% of TEA recorded in such a cohort.
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20
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Nicastro N, Picard F, Assal F. Transient global amnesia mimics: Transient epileptic amnesia. Epilepsy Behav Case Rep 2014; 2:100-1. [PMID: 25667881 PMCID: PMC4308042 DOI: 10.1016/j.ebcr.2014.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 03/25/2014] [Indexed: 11/06/2022]
Abstract
We describe the case of a 79-year-old patient referred for suspected transient global amnesia, after an episode of anterograde amnesia which lasted 90 min. An EEG, performed after the episode, showed bilateral temporal electrographic seizures, orienting the diagnosis toward a transient epileptic amnesia. Transient epileptic amnesia is defined by temporal lobe epilepsy characterized by recurrent transient amnestic episodes of 30–90 min in duration, sometimes associated with olfactory hallucinations or oral automatisms. Response to antiepileptic drugs is excellent. We would like to raise awareness toward this epileptic amnesia when facing atypical or recurrent transient amnestic episodes.
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Affiliation(s)
- Nicolas Nicastro
- Department of Neurology, Geneva University Hospital, Switzerland
| | - Fabienne Picard
- Department of Neurology, Geneva University Hospital, Switzerland
| | - Frederic Assal
- Department of Neurology, Geneva University Hospital, Switzerland
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21
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Atherton KE, Nobre AC, Zeman AZ, Butler CR. Sleep-dependent memory consolidation and accelerated forgetting. Cortex 2014; 54:92-105. [PMID: 24657478 PMCID: PMC4007033 DOI: 10.1016/j.cortex.2014.02.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/28/2014] [Accepted: 02/10/2014] [Indexed: 11/26/2022]
Abstract
Accelerated long-term forgetting (ALF) is a form of memory impairment in which learning and initial retention of information appear normal but subsequent forgetting is excessively rapid. ALF is most commonly associated with epilepsy and, in particular, a form of late-onset epilepsy called transient epileptic amnesia (TEA). ALF provides a novel opportunity to investigate post-encoding memory processes, such as consolidation. Sleep is implicated in the consolidation of memory in healthy people and a deficit in sleep-dependent memory consolidation has been proposed as an explanation for ALF. If this proposal were correct, then sleep would not benefit memory retention in people with ALF as much as in healthy people, and ALF might only be apparent when the retention interval contains sleep. To test this theory, we compared performance on a sleep-sensitive memory task over a night of sleep and a day of wakefulness. We found, contrary to the hypothesis, that sleep benefits memory retention in TEA patients with ALF and that this benefit is no smaller in magnitude than that seen in healthy controls. Indeed, the patients performed significantly more poorly than the controls only in the wake condition and not the sleep condition. Patients were matched to controls on learning rate, initial retention, and the effect of time of day on cognitive performance. These results indicate that ALF is not caused by a disruption of sleep-dependent memory consolidation. Instead, ALF may be due to an encoding abnormality that goes undetected on behavioural assessments of learning, or by a deficit in memory consolidation processes that are not sleep-dependent.
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Affiliation(s)
- Kathryn E Atherton
- Department of Experimental Psychology, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
| | - Anna C Nobre
- Department of Experimental Psychology, University of Oxford, Oxford, UK; Oxford Centre for Human Brain Activity, University of Oxford, Oxford, UK
| | - Adam Z Zeman
- Cognitive and Behavioural Neurology Research Group, University of Exeter Medical School, UK
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22
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Abstract
Transient epileptic amnesia (TEA) is a distinctive syndrome and comprises episodic transient amnesia with an epileptic basis, without impairment of other aspects of cognitive function. Additional interictal memory deficits are common in TEA. An epileptic origin, after other etiologies have been excluded, should be considered and carefully investigated in patients complaining of isolated memory disturbances, particularly with recurrent short-lasting amnesic attacks. In all suspected cases of epilepsy, a detailed clinical history is of paramount importance, but ancillary tests including EEG and MRI could be very helpful. Transient epileptic amnesia is typically a benign and treatable condition. Future studies should investigate the exact mechanism(s) of this unique syndrome.
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Affiliation(s)
- Ali A Asadi-Pooya
- Neurosciences Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, USA.
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23
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Butler C, van Erp W, Bhaduri A, Hammers A, Heckemann R, Zeman A. Magnetic resonance volumetry reveals focal brain atrophy in transient epileptic amnesia. Epilepsy Behav 2013; 28:363-9. [PMID: 23832133 DOI: 10.1016/j.yebeh.2013.05.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 05/20/2013] [Indexed: 12/19/2022]
Abstract
Transient epileptic amnesia (TEA) is a recently described epilepsy syndrome characterized by recurrent episodes of isolated memory loss. It is associated with two unusual forms of interictal memory impairment: accelerated long-term forgetting (ALF) and autobiographical amnesia. We investigated the neural basis of TEA using manual volumetry and automated multi-atlas-based segmentation of whole-brain magnetic resonance imaging data from 40 patients with TEA and 20 healthy controls. Both methods confirmed the presence of subtle, bilateral hippocampal atrophy. Additional atrophy was revealed in perirhinal and orbitofrontal cortices. The volumes of these regions correlated with anterograde memory performance. No structural correlates were found for ALF or autobiographical amnesia. The results support the hypothesis that TEA is a focal medial temporal lobe epilepsy syndrome but reveal additional pathology in connected brain regions. The unusual interictal memory deficits of TEA remain unexplained by structural pathology and may reflect physiological disruption of memory networks by subclinical epileptiform activity.
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Affiliation(s)
- Christopher Butler
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
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