Skip to main content

Aetiopathogenesis of TGA

  • Chapter
  • First Online:
Transient Global Amnesia
  • 524 Accesses

Abstract

This chapter considers the aetiopathogenesis of TGA, examining the evidence for and against the commonly considered possibilities, including cerebrovascular changes (arterial or venous), epilepsy, and migraine. At the time of writing, the aetiopathogenesis of TGA remains enigmatic, and the possibility that this is a heterogeneous disorder cannot be excluded.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Agosti C, Borroni B, Archetti S, Akkawi N, Padovani A. The brain-derived neurotrophic factor (BDNF) Val66Met polymorphism is not significantly correlated to transient global amnesia: preliminary results of an on-going study in Brescia Province, Italy. Neurosci Lett. 2008;443:228–31.

    Article  CAS  PubMed  Google Scholar 

  • Alblas CL, Beneder PR, Bulens C. Transient global amnesia: indications for a syndrome involving cerebral venous stasis [in Dutch]. Ned Tijdschr Geneeskd. 2006;150:1685–8.

    CAS  PubMed  Google Scholar 

  • Arena JE, Rabinstein AA. In reply – familial transient global amnesia. Mayo Clin Proc. 2015;90:697.

    Article  PubMed  Google Scholar 

  • Attarian S, Michel B, Delaforte C, Chave B, Gastaut JL. A case of transient amnesia caused by cerebral thrombophlebitis: contribution of neuroimaging to physiopathogenesis of transient amnesia [in French]. Rev Neurol (Paris). 1995;151:552–8.

    CAS  Google Scholar 

  • Baezner H, Blahak C, Capelle HH, Schrader C, Lutjens G, Krauss JK. Transient global amnesia associated with accidental high-frequency stimulation of the right hippocampus in deep brain stimulation for segmental dystonia. Stereotact Funct Neurosurg. 2013;91:335–7.

    Article  PubMed  Google Scholar 

  • Baracchini C, Farina F, Ballotta E, Meneghetti G, Manara R. No signs of intracranial arterial vasoconstriction in transient global amnesia. J Neuroimaging. 2015;25:92–6.

    Article  PubMed  Google Scholar 

  • Baracchini C, Tonello S, Farina F, et al. Jugular veins in transient global amnesia: innocent bystanders. Stroke. 2012;43:2289–92.

    Article  PubMed  Google Scholar 

  • Bartsch T, Alfke K, Stingele R, et al. Selective affection of hippocampal CA-1 neurons in patients with transient global amnesia without long-term sequelae. Brain. 2006;129:2874–84.

    Article  CAS  PubMed  Google Scholar 

  • Bartsch T, Deuschl G. Transient global amnesia: functional anatomy and clinical implications. Lancet Neurol. 2010;9:205–14.

    Article  PubMed  Google Scholar 

  • Bender MB. Syndrome of isolated episode of confusion with amnesia. J Hillside Hosp. 1956;5:212–5.

    Google Scholar 

  • Bender MB. Single episode of confusion with amnesia. Bull NY Acad Med. 1960;36:197–207.

    CAS  Google Scholar 

  • Bolwig TG. Transient global amnesia. Acta Neurol Scand. 1968;44:101–6.

    Article  CAS  PubMed  Google Scholar 

  • Caplan LB [sic]. Transient global amnesia. In: Frederiks JAM, editor. Handbook of clinical neurology. Volume 1 (45). Clinical neuropsychology. Amsterdam: Elsevier Science Publishers; 1985. p. 205–18.

    Google Scholar 

  • Caplan LR. Transient global amnesia and jugular vein incompetence. Stroke. 2010;41:e568.

    Article  PubMed  Google Scholar 

  • Caplan L, Chedru F, Lhermitte F, Mayman C. Transient global amnesia and migraine. Neurology. 1981;31:1167–70.

    Article  CAS  PubMed  Google Scholar 

  • Castellani JW, Young AJ, Sawka MN, Backus VL, Canete JJ. Amnesia during cold water immersion: a case report. Wilderness Environ Med. 1998;9:153–5.

    Article  CAS  PubMed  Google Scholar 

  • Cho HJ, Sung YH, Lee SH, Chung JY, Kang JM, Yi JW. Isoflurane induces transient anterograde amnesia through suppression of brain-derived neurotrophic factor in hippocampus. J Korean Neurosurg Soc. 2013;53:139–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Crowell GF, Stump DA, Biller J, McHenry Jr LC, Toole JF. The transient global amnesia-migraine connection. Arch Neurol. 1984;41:75–9.

    Article  CAS  PubMed  Google Scholar 

  • Donnet A. Transient global amnesia triggered by migraine in a French tertiary-care center: an 11-year retrospective analysis. Headache. 2015;55:853–9.

    Article  PubMed  Google Scholar 

  • Fisher CM. Transient global amnesia. Precipitating activities and other observations. Arch Neurol. 1982;39:605–8.

    Article  CAS  PubMed  Google Scholar 

  • Fisher CM, Adams RD. Transient global amnesia. Trans Am Neurol Assoc. 1958;83:143–6.

    Google Scholar 

  • Fisher CM, Adams RD. Transient global amnesia. Acta Neurol Scand. 1964;40(Suppl 9):1–81.

    Google Scholar 

  • Förster A, Griebe M, Gass A, Kern R, Hennerici MG, Szabo K. Diffusion-weighted imaging for the differential diagnosis of disorders affecting the hippocampus. Cerebrovasc Dis. 2012;33:104–15.

    Article  PubMed  Google Scholar 

  • Frederiks JAM. Transient global amnesia: an amnesic TIA. In: Markowitsch HJ, editor. Transient global amnesia and related disorders. Toronto: Hogrefe and Huber; 1990. p. 28–47.

    Google Scholar 

  • Gorji A. Spreading depression: a review of the clinical relevance. Brain Res Brain Res Rev. 2001;38:33–60.

    Article  CAS  PubMed  Google Scholar 

  • Guidotti M, Anzalone N, Morabito A, Landi G. A case-control study of transient global amnesia. J Neurol Neurosurg Psychiatry. 1989;52:320–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Guyotat MM, Courjon J. Les ictus amnésiques. J Med Lyon. 1956;37:697–701.

    PubMed  Google Scholar 

  • Hartings JA, Shuttleworth CW, Kirov SA, et al. The continuum of spreading depolarizations in acute cortical lesion development: examining Leão’s legacy. J Cereb Blood Flow Metab. 2016. pii: 0271678X16654495. [Epub ahead of print]

    Google Scholar 

  • Hebb DO. The organization of behavior: a neuropsychological theory. New York: Wiley; 1949.

    Google Scholar 

  • Hodges JR. Transient amnesia. Clinical and neuropsychological aspects. London: WB Saunders; 1991.

    Google Scholar 

  • Hodges JR. Unraveling the enigma of transient global amnesia. Ann Neurol. 1998;43:151–3.

    Article  CAS  PubMed  Google Scholar 

  • Hodges JR, Warlow CP. The aetiology of transient global amnesia. A case-control study of 114 cases with prospective follow-up. Brain. 1990;113:639–57.

    Article  PubMed  Google Scholar 

  • Jang JW, Park SY, Hong JH, Park YH, Kim JE, Kim S. Different risk factor profiles between transient global amnesia and transient ischemic attack: a large case-control study. Eur Neurol. 2014;71:19–24.

    Article  PubMed  Google Scholar 

  • Kanzer M. Amnesia. A statistical study. Am J Psychiatry. 1939;96:711–6.

    Article  Google Scholar 

  • Kennedy A, Neville J. Sudden loss of memory. BMJ. 1957;2:428–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Klötzsch C, Sliwka U, Berlit P, Noth J. An increased frequency of patent foramen ovale in patients with transient global amnesia. Analysis of 53 consecutive patients. Arch Neurol. 1996;53:504–8.

    Article  PubMed  Google Scholar 

  • Lane R, Davies P. Migraine. New York: Taylor & Francis; 2006.

    Google Scholar 

  • Larner AJ. Transient global amnesia in the district general hospital. Int J Clin Pract. 2007;61:255–8.

    Article  CAS  PubMed  Google Scholar 

  • Larner AJ. Transient acute neurologic sequelae of sexual activity: headache and amnesia. J Sex Med. 2008;5:284–8.

    Article  PubMed  Google Scholar 

  • Laureno R. Raymond Adams. A life of mind and muscle. Oxford: Oxford University Press; 2009.

    Google Scholar 

  • Lauritzen M. On the possible relation of spreading cortical depression to classical migraine. Cephalalgia. 1985;5(Suppl 2):47–51.

    PubMed  Google Scholar 

  • Leão AAP. Spreading depression of activity in the cerebral cortex. J Neurophysiol. 1944;7:359–90.

    Google Scholar 

  • Leisman G, Koch P. Continuum model of mnemonic and amnesic phenomena. J Int Neuropsychol Soc. 2000;6:593–607.

    Article  CAS  PubMed  Google Scholar 

  • Lewis SL. Aetiology of transient global amnesia. Lancet. 1998;352:397–9.

    Article  CAS  PubMed  Google Scholar 

  • Lin KH, Chen YT, Fuh JL, et al. Migraine is associated with a higher risk of transient global amnesia: a nationwide cohort study. Eur J Neurol. 2014;21:718–24.

    Article  PubMed  Google Scholar 

  • Lochner P, Nedelmann M, Kaps M, Stolz E. Jugular valve incompetence in transient global amnesia. A problem revisited. J Neuroimaging. 2014;24:479–83.

    Article  PubMed  Google Scholar 

  • Melo TP, Ferro JM, Ferro H. Transient global amnesia. A case control study. Brain. 1992;115:261–70.

    Article  PubMed  Google Scholar 

  • Menendez-Gonzalez M, Rivera MM. Transient global amnesia: increasing evidence of a venous etiology. Arch Neurol. 2006;63:1334–6.

    Article  PubMed  Google Scholar 

  • Milner PM. Note on a possible correspondence between the scotomas of migraine and spreading depression of Leão. Electroencephalogr Clin Neurophysiol. 1958;10:705.

    Article  CAS  PubMed  Google Scholar 

  • Modabbernia A, Taslimi S, Ashrafi M, Modabbernia MJ, Hu HH. Internal jugular vein reflux in patients with transient global amnesia: a meta-analysis of case-control studies. Acta Neurol Belg. 2012;112:237–44.

    Article  PubMed  Google Scholar 

  • Moon Y, Oh J, Kwon KJ, Han SH. Transient global amnesia: only in already disrupted neuronal integrity of memory network? J Neurol Sci. 2016;368:187–90.

    Article  PubMed  Google Scholar 

  • Moreno-Lugris XC, Martinez-Alvarez J, Branas F, Martinez-Vazquez F, Cortes-Laino JA. Transient global amnesia. Case-control study of 24 cases [in Spanish]. Rev Neurol. 1996;24:554–7.

    CAS  PubMed  Google Scholar 

  • Olesen J, Jorgensen MB. Leao’s spreading depression in the hippocampus explains transient global amnesia. A hypothesis. Acta Neurol Scand. 1986;73:219–20.

    Article  CAS  PubMed  Google Scholar 

  • Park YH, Kim JY, Yi S, et al. Transient global amnesia deteriorates the network efficiency of the theta band. PLoS One. 2016;11:e0164884.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pearce JM. Is migraine explained by Leão’s spreading depression? Lancet. 1985;2:763–6.

    Article  CAS  PubMed  Google Scholar 

  • Pearce JMS, Bogousslavsky J. “Les ictus amnésiques” and transient global amnesia. Eur Neurol. 2009;62:188–92.

    Article  CAS  PubMed  Google Scholar 

  • Poser CM, Ziegler DK. Temporary amnesia as a manifestation of cerebrovascular insufficiency. Trans Am Neurol Assoc. 1960;85:221–3.

    CAS  PubMed  Google Scholar 

  • Quinette P, Guillery-Girard B, Dayan J, de la Sayette V, Marquis S, Viader F, Desgranges B, Eustache F. What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases. Brain 2006;129:1640–58.

    Google Scholar 

  • Roach ES. Transient global amnesia: look at mechanisms not causes. Arch Neurol. 2006;63:1338–9.

    Article  CAS  PubMed  Google Scholar 

  • Rösler A, Mras GJ, Frese A, Albert I, Schnorpfeil F. Precipitating factors of transient global amnesia. J Neurol. 1999;246:53–4.

    Article  PubMed  Google Scholar 

  • Santoro G, Casadei B, Venco A. The transient global amnesia-migraine connection. Case report Funct Neurol. 1988;3:353–60.

    CAS  PubMed  Google Scholar 

  • Schmidtke K, Ehmsen L. Transient global amnesia and migraine. A case control study. Eur Neurol. 1998;40:9–14.

    Article  CAS  PubMed  Google Scholar 

  • Schmitz B, Tettenborn B, Schomer DL, editors. The paroxysmal disorders. Cambridge: Cambridge University Press; 2010.

    Google Scholar 

  • Segers-van Rijn J, de Bruijn SFTM. Transient global amnesia: a genetic disorder? Eur Neurol. 2010;63:186–7.

    Article  PubMed  Google Scholar 

  • Sharma RC, Kainth A, Sharma S. Transient global amnesia as a presenting manifestation of cerebral venous thrombosis. J Neuropsychiatry Clin Neurosci. 2015;27:e209–10.

    Article  PubMed  Google Scholar 

  • Sherzai AZ, Yi M, Tseng P, Shavlik D, Ghamsary M, Sherzai D. Trends in demographic, comorbidity profile associated with transient global amnesia: a nationwide inpatient sample analysis. 2017. submitted.

    Google Scholar 

  • Solheim O, Skeidsvoll T. Transient global amnesia may be caused by cerebral vein thrombosis. Med Hypotheses. 2005;65:1142–9.

    Article  PubMed  Google Scholar 

  • Strupp M, Brüning R, Wu RH, Deimling M, Reiser M, Brandt T. Diffusion-weighted MRI in transient global amnesia: elevated signal intensity in the left mesial temporal lobe in 7 out of 10 patients. Ann Neurol. 1998;43:164–70.

    Article  CAS  PubMed  Google Scholar 

  • Toledo M, Pujadas F, Grivé E, Alvarez-Sabin J, Quintana M, Rovira A. Lack of evidence for arterial ischemia in transient global amnesia. Stroke. 2008;39:476–9.

    Article  PubMed  Google Scholar 

  • Toledo M, Pujadas F, Purroy F, Lara N, Quintana M, Alvarez-Sabin J. Recurrent transient global amnesia, a manifestation of ischemic cerebrovascular disease [in Spanish]. Med Clin (Barc). 2005;125:361–5. [Erratum Med Clin (Barc). 2006; 126:316]

    Article  Google Scholar 

  • Ung KYC, Larner AJ. Transient amnesia: epileptic or global? A differential diagnosis with significant implications for management. Q J Med. 2014;107:915–7.

    Google Scholar 

  • Whitty CWM, Lishman WA. Amnesia in cerebral disease. In: Whitty CWM, Zangwill OL, editors. Amnesia. London: Butterworths; 1966. p. 36–76.

    Google Scholar 

  • Zola-Morgan S, Squire LR, Amaral DG. Human amnesia and the medial temporal region: enduring memory impairment following a bilateral lesion limited to field CA1 of the hippocampus. J Neurosci. 1986;6:2950–67.

    Google Scholar 

  • Zorzon M, Antonutti L, Mase G, Biasutti E, Vitrani B, Cazzato G. Transient global amnesia and transient ischemic attack. Natural history, vascular risk factors, and associated conditions. Stroke. 1995;26:1536–42.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Larner, A.J. (2017). Aetiopathogenesis of TGA. In: Transient Global Amnesia. Springer, Cham. https://doi.org/10.1007/978-3-319-54476-2_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-54476-2_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54474-8

  • Online ISBN: 978-3-319-54476-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics