scholarly journals A Forgetful Experience: A Case of Transient Global Amnesia

1970 ◽  
Vol 9 (4) ◽  
Author(s):  
Kalpa Shah MD PGY2 ◽  
Chris Sheasgreen MD PGY3 ◽  
Ameen Patel MB
Keyword(s):  
Transient Global Amnesia ◽  
Acute Onset ◽  
Clinical Syndrome ◽  
Benign Condition ◽  
Clinical Criteria ◽  
Global Amnesia ◽  
Criteria For Diagnosis ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

We present a case of a 67-year-old man with transient global amnesia, a clinical syndrome that presents with an acute onset of temporary amnesia lasting less than 24 hours, without impairment of consciousness or cognition. In this article, we discuss the clinical criteria for diagnosis, the pathophysiology of the condition, and an approach to its diagnostic work-up and prognosis. It is important to differentiate TGA from other entities because it is a benign condition that does not require treatment.

scholarly journals Transient global amnesia: Isolated event or healthy predictor? Clinical experience of an Italian Emergency Department

2019 ◽  
Vol 15 (3) ◽  
Author(s):  
Greta Barbieri ◽  
Alessandro Cipriano ◽  
Simona Luly ◽  
Viola Del Nista ◽  
Eugenio Orsitto ◽  
...  
Keyword(s):  
Emergency Department ◽  
Neurological Diseases ◽  
Transient Global Amnesia ◽  
Anterograde Amnesia ◽  
Acute Onset ◽  
Clinical Syndrome ◽  
Neurological Symptoms ◽  
Self Awareness ◽  
Benign Pathology ◽  
Global Amnesia

Transient global amnesia (TGA) is a clinical syndrome characterized by reversible anterograde amnesia, in which the patient is alert, self-awareness appears intact and other neurological symptoms are absent. The diagnosis is based on the following criteria: i) witnessed event; ii) acute onset of anterograde amnesia; iii) no accompanying neurological symptoms; iv) no alteration of consciousness; v) no epileptic features; vi) resolution within 24 hours; vii) exclusion of other causes. We conducted a cohort study at the Department of Emergency Medicine on 119 patients with TGA diagnosis from 2010 to 2014, with follow-up evaluation by telephone interview. The objectives of our study were to evaluate the frequency of subsequent episodes, to identify predisposing factors, and to investigate whether TGA is a possible predictor of neurological disease. The frequency of comorbidity in our population was in line with literature. We observed a recurrence rate of 9.5%, with a prevalence for the male gender, while no other factor correlates with TGA recurrence. TGA was not a predictor of further neurological diseases. In conclusion, TGA is a benign pathology with a low probability of relapse. Accordingly, management in Emergency Department should be based on a correct initial clinical classification for rapid discharge.

scholarly journals Exertional rhabdomyolysis: Relevance of clinical and laboratory findings, and clues for investigation

2019 ◽  
Vol 47 (2) ◽  
pp. 128-133 ◽  
Author(s):  
Karel Heytens ◽  
Willem De Ridder ◽  
Jan De Bleecker ◽  
Luc Heytens ◽  
Jonathan Baets
Keyword(s):  
Striated Muscle ◽  
Clinical Syndrome ◽  
Strenuous Exercise ◽  
Laboratory Findings ◽  
Underlying Condition ◽  
Exertional Rhabdomyolysis ◽  
Patients At Risk ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Some degree of exertional rhabdomyolysis (ER), striated muscle breakdown associated with strenuous exercise, is a well-known phenomenon associated with endurance sports. However in rare cases, severe and/or recurrent ER is a manifestation of an underlying condition, which puts patients at risk for significant morbidity and mortality. Selecting the patients that need a diagnostic work up of an acute rhabdomyolysis episode is an important task. Based on the diagnostic work up of three illustrative patients treated in our hospital, retrospectively using the ‘RHABDO’ screening tool, we discuss the clinical and biochemical clues that should trigger further investigation for an underlying condition. Finally, we describe the most common genetic causes of this clinical syndrome.

scholarly journals Transient Global Amnesia in a Collegiate Baseball Player with Type I Diabetes Mellitus: A Case Report

2011 ◽  
Vol 46 (3) ◽  
pp. 319-321 ◽  
Author(s):  
Jocelyn R. Gravlee ◽  
John J. Barrett
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Type I Diabetes ◽  
Transient Global Amnesia ◽  
Acute Onset ◽  
Type I Diabetes Mellitus ◽  
Type I ◽  
Benign Condition ◽  
Memory Disturbance ◽  
Global Amnesia

Objective: To present the case of a collegiate pitcher with type I diabetes mellitus who developed transient global amnesia and to characterize the acute onset of symptoms and clinical diagnosis of this rarely reported neurologic condition in the student-athlete population. Background: A 21-year-old collegiate pitcher with type I diabetes mellitus was found by his roommate to have acute-onset memory loss. The athletic trainer identified normal blood glucose levels and normal vital signs but profound amnesia. The patient was evaluated by his team physician and referred to the local emergency department for acute-onset memory disturbance. Differential Diagnosis: Hypoglycemia, ketoacidosis, adverse drug reaction, infectious disease, transient epileptic amnesia, transient ischemic attack, acute confusional state, complex partial seizure, psychogenic amnesia, migraine, intracerebral hemorrhage, traumatic brain injury, tumor, and transient global amnesia. Treatment: Diagnostic studies included computed tomography of the head, urine and serum toxicology, urinalysis, blood glucose level, electrolytes, blood urea nitrogen level, creatinine level, complete blood count, and electroencephalography. The patient was admitted overnight to the neurology service. The next morning, electroencephalography was repeated, and magnetic resonance imaging of the head with contrast was performed. The patient was discharged with the diagnosis of transient global amnesia. Uniqueness: Transient global amnesia is considered a benign condition characterized by an acute episode of memory disturbance involving the inability to form new memories and recall recent events. It is rare in young people, with only 3 case reports involving young athletes published in the literature. Conclusions: Transient global amnesia is a rarely diagnosed neurologic disturbance that may present acutely in student–athletes, although most reported cases affect older adults. Un-familiarity with the symptoms may cause anxiety for the athlete and bystanders. Transient global amnesia does not result in long-term neurologic deficit, and neurologic function will return to baseline.

scholarly journals Stroke masquerading as cardiac arrest: the artery of Percheron

2021 ◽  
Vol 14 (1) ◽  
pp. e238681
Author(s):  
Megan Quetsch ◽  
Sureshkumar Nagiah ◽  
Stephen Hedger
Keyword(s):  
Cardiac Arrest ◽  
Clinical Assessment ◽  
Altered Consciousness ◽  
Cognitive Changes ◽  
Consciousness Level ◽  
Artery Of Percheron ◽  
Conscious Level ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

The artery of Percheron (AOP) is a rare arterial variant of the thalamic blood supply. Due to the densely packed collection of nuclei it supplies, an infarction of the AOP can be devastating. Here we highlight a patient who had an AOP stroke in the community, which was initially managed as cardiac arrest. AOP strokes most often present with vague symptoms such as reduced conscious level, cognitive changes and confusion without obvious focal neurology, and therefore are often missed at the initial clinical assessment. This case highlights the importance of recognising an AOP stroke as a cause of otherwise unexplained altered consciousness level and the use of MRI early in the diagnostic work-up.

scholarly journals Death of unknown cause? Post-mortem diagnosis of fulminant course of an EBV-associated secondary hemophagocytic lymphohistiocytosis

2021 ◽  
Author(s):  
Josia Fauser ◽  
Stefan Köck ◽  
Eberhard Gunsilius ◽  
Andreas Chott ◽  
Andreas Peer ◽  
...  
Keyword(s):  
Immune Response ◽  
Case Report ◽  
Macrophage Activation ◽  
Post Mortem ◽  
Life Threatening ◽  
Appropriate Therapy ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up ◽  
Secondary Hemophagocytic Lymphohistiocytosis

SummaryHLH is a life-threatening disease, which is characterized by a dysregulated immune response with uncontrolled T cell and macrophage activation. The often fulminant course of the disease needs a fast diagnostic work-up to initiate as soon as possible the appropriate therapy. We present herein the case of a 71-year-old patient with rapidly progressive hyperinflammatory syndrome, which post mortem resulted in the diagnosis of EBV-associated HLH. With this case report, we intend to highlight the relevance of the HScore in the diagnosis of HLH, to create a greater awareness for EBV as a trigger of HLH, and to demonstrate the importance of treating EBV-associated HLH as early as possible.

scholarly journals COVID-19 lung injury as a primer for immune checkpoint inhibitors (ICIs)-related pneumonia in a patient affected by squamous head and neck carcinoma treated with PD-L1 blockade: a case report

2021 ◽  
Vol 9 (2) ◽  
pp. e001870
Author(s):  
Angelo Dipasquale ◽  
Pasquale Persico ◽  
Elena Lorenzi ◽  
Daoud Rahal ◽  
Armando Santoro ◽  
...  
Keyword(s):  
Lung Injury ◽  
Head And Neck ◽  
Checkpoint Inhibitors ◽  
Experimental Therapy ◽  
Common Mechanism ◽  
Nasopharyngeal Swab ◽  
Immune Mediated ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

By the beginning of the global pandemic, SARS-CoV-2 infection has dramatically impacted on oncology daily practice. In the current oncological landscape, where immunotherapy has revolutionized the treatment of several malignancies, distinguishing between COVID-19 and immune-mediated pneumonitis can be hard because of shared clinical, radiological and pathological features. Indeed, their common mechanism of aberrant inflammation could lead to a mutual and amplifying interaction.We describe the case of a 65–year-old patient affected by metastatic squamous head and neck cancer and candidate to an experimental therapy including an anti-PD-L1 agent. COVID-19 ground-glass opacities under resolution were an incidental finding during screening procedures and worsened after starting immunotherapy. The diagnostic work-up was consistent with ICIs-related pneumonia and it is conceivable that lung injury by SARS-CoV-2 has acted as an inflammatory primer for the development of the immune-related adverse event.Patients recovered from COVID-19 starting ICIs could be at greater risk of recall immune-mediated pneumonitis. Nasopharyngeal swab and chest CT scan are recommended before starting immunotherapy. The awareness of the phenomenon could allow an easier interpretation of radiological changes under treatment and a faster diagnostic work-up to resume ICIs. In the presence of clinical benefit, for asymptomatic ICIs-related pneumonia a watchful-waiting approach and immunotherapy prosecution are suggested.

scholarly journals Long-Term Follow-Up of Thyroid Incidentalomas Visualized with 18F-Fluorodeoxyglucose Positron Emission Tomography—Impact of Thyroid Scintigraphy in the Diagnostic Work-Up

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 557
Author(s):  
Kirsten Korsholm ◽  
Michala Reichkendler ◽  
Louise Alslev ◽  
Åse Krogh Rasmussen ◽  
Peter Oturai
Keyword(s):  
Emission Tomography ◽  
Thyroid Scintigraphy ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Diagnostic Work ◽  
Fdg Pet Ct ◽  
Work Up ◽  
Diagnostic Work Up

Our objective was to evaluate the frequency of malignancy in incidental thyroidal uptake on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in a cohort of Danish patients, and furthermore to evaluate the impact of thyroid scinti-graphy in the diagnostic work-up. All whole-body PET/CT reports from 1 January 2010 to 31 December 2013 were retrospectively reviewed and further analyzed if visually increased thyroidal FDG uptake was reported. Patient electronic files were searched for further thyroid evaluation. Of 13,195 18F-FDG-PET/CT scans in 9114 patients, 312 PET/CT reports mentioned incidental thyroid FDG-uptake, and 279 patients were included in the study (3.1%). The thyroid was further investigated in 137 patients (49%), and 75 patients underwent thyroid scintigraphy. A total of 57 patients had a thyroid biopsy and 21 proceeded to surgery. Surgical specimens displayed malignancy in 10 cases, and one thyroid malignancy was found by autopsy. Hence, 11 patients were diagnosed with thyroid malignancies among 279 patients with incidental thyroid 18F-FDG uptake (3.9%). In 34 patients, a biopsy was avoided due to the results of the thyroid scintigraphy. We conclude that patients with thyroid incidentalomas can benefit from further diagnostic work-up including a thyroid scintigraphy.

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