短暂性全面遗忘的临床及影像特点分析

Clinical and imaging features of transient global amnesia

目的:探讨短暂性全面遗忘的临床特点以及影像学特征。方法:回顾分析2010年1月〜2018年12月中日友好医院神经内科收治的42例短暂性全面遗忘患者的临床及影像学资料,并结合文献进行分析:结果:42例中男16例,女26例,平均年龄65.7岁16例由Valsalva动作诱发,临床表现为突发的一过性时间、地点定向障碍伴顺行性遗忘,部分患者伴逆行性遗忘及其他认知域损害,症状平均持续5.2h。6例患者发病24〜96 h时,磁共振弥散加权出现单侧海马区点状高信号其他辅助检查无明显特异性。预后好,少见复发。结论:短暂性全面遗忘的诊断主要依靠详尽的病史,磁共振弥散加权出现单侧海马区点状高信号可以辅助诊断。

Objective:To investigate the clinical and imaging features and pathogenesis of transient global amnesia.Methods:The clinical data of 42 patients with transient global amnesia admitted to China-Japan Friendship Hospital from January 2010 to December 2018 were analyzed retrospectively.Results:There were 16 male and 26 female patients with an average age of 65.7 years in this study.Sixteen cases were induced by Valsalva's maneuver.The clinical symptoms characterized by sudden onset of anterograde amnesia,accompanied by disorientation of time and place,sometimes with a retrograde amnesia and other cognitive domain impairment.The symptoms lasted less than 24 hours with an average lentil of 5.2 hours.Magnetic resonance imaging performed within 24 to 96 hours showed unilateral hippocampal punctate hyperintense signals on diffusionweighted imaging in 6 patients.Other auxiliary examinations showed no obvious specificity.All patients had good prognosis and recurrence was rarely seen.Conclusion:The diagnosis of transient global amnesia mainly depends on a detailed medical history,unilateral hippocampal punctate hyperintense signals on diffusion-weighted imaging may be helpful.