Increased troponin levels can ­detect transient global amnesia mimics

Abstract

Transient global amnesia (TGA) is an idiopathic entity with a complete loss of memory acquisition that resolves within a few hours. Patients demonstrate no other neurological or cognitive deficits, there is no loss of personal identity, previously acquired skills are not impaired, and characteristically they seem to realise that something is amiss and keep asking the same questions. Although the underlying pathophysiology still remains an enigma, we know from experience that physical or emotional stress are possible triggers [1]. The diagnosis of TGA is based on the clinical criteria set out by Hodges and Warlow [2]. Diffusion-weighted magnetic resonance imaging (DWI) can support a diagnosis of TGA and rule out other causes of amnesia, for example certain types of ischaemic stroke. Unior bilateral punctate DWI lesions can be detected in the hippocampus 24–72 hours after the initial symptoms in up to three quarters of TGA patients [1]. A non-punctate DWI signal in the hippocampus and/or extra-hippocampal DWI lesions are characteristic of ischaemic amnesia. This minireview examines the question of how often DWI shows that the clinical diagnosis of TGA was wrong and amnesia was caused by stroke.