高同型半胱氨酸血症与短暂性全身性遗忘:一罕见病例报告。

Rafay Khan, Mohammad A Hossain, Qiang Nai, Abdalla M Yousif, Shraman Sen
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引用次数: 2

摘要

背景:短暂性全身性遗忘症(TGA)是一种有趣的疾病,通常表现为突然发作的暂时性完全顺行性遗忘和部分逆行性遗忘。大多数患有这种形式的健忘症的人通常只有一次发作,但也有可能反复发作。大多数发作持续几分钟或几个小时,形成新记忆的能力也可能受到影响,但会逐渐改善,在发作期间只留下一段严重的失忆间隙。关于TGA的病因有一些讨论;然而,对于任何重要的关联,尚未达成共识。病例报告:我们报告一例65岁男性,表现为突然发作的记忆丧失,这是典型的TGA,他被发现有升高的同型半胱氨酸水平。以前只报道过另一个病例,讨论了高同型半胱氨酸血症与TGA之间可能的相关性。同型半胱氨酸水平升高是否是TGA发作的重要危险因素尚不清楚。结论:尽管早在半个多世纪前就被首次描述,但由于许多医生对这种疾病不熟悉,它仍然经常被误诊。此外,有相当多的医疗条件可能会导致突然的记忆障碍,如癫痫和中风,这使得很难将它们与这种形式的健忘症区分开来。了解这些临床特征对于高度怀疑是必要的,这可能导致进行适当诊断所需的细致医学评估。
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Hyperhomocysteinemia Association With Transient Global Amnesia: A Rare Case Report.

Context: Transient global amnesia (TGA) is an intriguing condition that classically presents with an abrupt onset of temporary complete anterograde amnesia and partial retrograde amnesia. Most individuals who experience such a form of amnesia usually have only one attack but recurrent attacks are possible. Most attacks last for a few minutes or few hours and the ability to lay down new memories may also be affected but gradually improves, leaving only a dense amnestic gap for the duration of the episode. There has been some discussion about the etiology behind TGA; however, there has yet to be a consensus with regard to any significant association.

Case report: We report the case of a 65-year-old male presenting with a sudden onset of memory loss that is typical of TGA and who was found to have elevated homocysteine levels. There has only been one other case previously reported that discussed a possible correlation between hyperhomocysteinemia and TGA. It is yet to be determined if increased homocysteine level is a significant risk factor for attacks of TGA.

Conclusion: Although it was first described more than half a century ago, it can still be misdiagnosed frequently as many physicians are not familiar with this condition. Furthermore, there are quite a few medical conditions that may cause sudden memory impairment, such as epilepsy and stroke, which make it difficult to distinguish them from this form of amnesia. The knowledge of these clinical identities is necessary for a high index of suspicion, which may lead to a meticulous medical evaluation as required for proper diagnosis.

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