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A case of transient epileptic amnesia with radiological localization

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From Nature Clinical Practice Neurology

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Abstract

Background A 54-year-old man presented to a cognitive disorders clinic having experienced recurrent episodes of transient amnesia over a number of years. The attacks often occurred on waking, did not affect other cognitive abilities such as perception, language or judgment, and typically lasted about half an hour. The attacks were sometimes associated with olfactory hallucinations. Between amnestic episodes, the patient noticed a gradual deterioration in his recall of remote events, despite normal performance on standard memory tests.

Investigations Physical examination, laboratory tests, EEG, MRI brain scan, PET imaging, and neuropsychological assessment.

Diagnosis Transient epileptic amnesia.

Management Anticonvulsant medication.

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Figure 1: Brain scans from a patient with transient epileptic amnesia.
Figure 2: Neuropsychological assessment of a patient with transient epileptic amnesia.
Figure 3: 4-Tesla fast spin-echo MRI sequence from a patient with transient epileptic amnesia.

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Acknowledgements

We would like to thank the patient and his family for their enthusiasm and help. Written consent for publication was obtained from the patient. We are grateful to Dr Susanne Mueller for assistance with the imaging data and to Professors John Hodges and Kim Graham for comments on previous versions of the manuscript. This work was supported by grants from the Patrick Berthoud Charitable Trust and The Health Foundation. Désirée Lie, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. CR Butler is Clinical Lecturer in Medical Neurology at the University of Edinburgh, Edinburgh, and A Zeman is Professor of Cognitive and Behavioural Neurology at the Peninsula Medical School, Exeter, UK.,

    Christopher R Butler & Adam Zeman

Authors
  1. Christopher R Butler
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  2. Adam Zeman
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Corresponding author

Correspondence to Christopher R Butler.

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The authors declare no competing financial interests.

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Butler, C., Zeman, A. A case of transient epileptic amnesia with radiological localization. Nat Rev Neurol 4, 516–521 (2008). https://doi.org/10.1038/ncpneuro0857

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