Clinical, neuropsychological, and metabolic characteristics of transient epileptic amnesia syndrome

Epilepsia. 2014 May;55(5):699-706. doi: 10.1111/epi.12565. Epub 2014 Mar 1.

Abstract

Objective: Transient epileptic amnesia (TEA) is a recently individualized syndrome occurring in adult patients that includes epileptic seizures with amnestic features and interictal memory disturbances.

Methods: We investigated the clinical, neuropsychological, and 18F-FDG positron emission tomography (18F-FDG-PET) features of 30 consecutive cases of TEA in our center.

Results: The mean age of onset of amnestic seizures was 59 years. Pure acute amnesia was the only epileptic manifestation in 17% of cases. Interictal electroencephalography (EEG) abnormalities were present in 57% on awake recording and in most patients in whom sleep EEG was performed (96%). Nine of 30 patients showed anterograde memory deficit and six of 30 exhibited mild executive functioning impairment. On the autobiographical memory interview (AMI), patients showed a significant deficit for the recent period of the episodic subscale. Outcome under treatment was favorable in the majority of cases. A significant improvement was noted on recollection of autobiographical memory. 18F-FDG-PET (22 cases) showed positive correlations between left mesial temporal metabolism levels and anterograde and retrograde memory scores.

Significance: TEA is an emerging epileptic syndrome that likely remains misidentified and misdiagnosed. Neurometabolic data support a dysfunction of a hippocampal-neocortical network sustaining episodic memory.

Keywords: Accelerated forgetting; Amnesia; EEG; Epilepsy; Episodic memory; FDG-PET.

MeSH terms

  • Aged
  • Amnesia, Anterograde / diagnosis*
  • Amnesia, Anterograde / drug therapy
  • Amnesia, Anterograde / physiopathology
  • Amnesia, Anterograde / psychology*
  • Anticonvulsants / therapeutic use
  • Dominance, Cerebral / drug effects
  • Dominance, Cerebral / physiology
  • Electroencephalography
  • Energy Metabolism / drug effects
  • Energy Metabolism / physiology*
  • Executive Function / drug effects
  • Executive Function / physiology*
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Image Interpretation, Computer-Assisted
  • Male
  • Memory, Episodic*
  • Middle Aged
  • Monitoring, Ambulatory
  • Neuropsychological Tests*
  • Positron-Emission Tomography*
  • Retrospective Studies
  • Signal Processing, Computer-Assisted
  • Statistics as Topic
  • Temporal Lobe / drug effects
  • Temporal Lobe / physiopathology*
  • Theta Rhythm / drug effects
  • Theta Rhythm / physiology
  • Wechsler Scales

Substances

  • Anticonvulsants
  • Fluorodeoxyglucose F18