RT Journal Article
SR Electronic
T1 Lesson of the month 2: Transient reversible amnesia in multiple sclerosis
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 88
OP 90
DO 10.7861/clinmedicine.17-1-88
VO 17
IS 1
A1 Priya Devi Shanmugarajah
A1 Jane Alty
A1 Oliver Lily
A1 Helen L Ford
YR 2017
UL http://www.rcpjournals.org/content/17/1/88.abstract
AB 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.