Two of the 16 patients suffered their second or third episode of TGA, respectively. None of them showed symptoms of Covid-19. 66.8 years 12 (75%) were female compared to 58% in the registry. The current TGA patients were slightly older than the more than 200 patients of our single center TGA registry with an average age of 70.8 vs. Accordingly, many stroke units recently reported lower admission rates of patients with TIA or minor strokes since the beginning of the pandemic. One might speculate that the real increase in TGA incidence was even bigger as some patients might have taken distance from presenting to an emergency department in fear of getting infected with SARS-CoV-2 there. Between February 1st and May 15th (when a loosening of the preventive restrictions came into effect because of the decline of new Covid-19 infections in Germany) we diagnosed 16 patients with TGA while the average number of patients in the same period over the last 10 years was 9.7 (SD 2.41, 95%CI 8.3–11.1). Since the Covid-19 outbreak in Germany at the end of January 2020 we have noticed an increasing number of patients with TGA in our neurological emergency department in a German academic teaching hospital. Its etiology is still a matter of debate: focal hippocampal ischemia, venous congestion, migraine- or epilepsy-like mechanisms, and metabolic stress have been hypothesized. It often occurs in the context of physical or emotional stress. Submitted comments are subject to editing and editor review prior to posting.The main clinical feature of transient global amnesia (TGA) is an acute anterograde memory disturbance that resolves within 24 h.Read any comments already posted on the article prior to submission. Submit only on articles published within 6 months of issue date.(Exception: original author replies can include all original authors of the article) Submissions should not have more than 5 authors.Reference 1 must be the article on which you are commenting. Submissions must be You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid If you are responding to a comment that was written about an article you originally authored: Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment. You must have updated your disclosures within six months: If you are uploading a letter concerning an article: 5,6 ⇓Ĭan MRI help provide answers? The profound nature of the memory deficit has encouraged speculation that … View Full Text The same group has reported that a significantly higher percentage of TGA patients possess jugular venous backflow with Valsalva compared with controls. 4 Interestingly, there is some support for this hypothesis. More recently, Lewis hypothesized that TGA was related to venous congestion due to retrograde venous cerebral blood flow, because of the commonly reported association between TGA and situations that result in reduced venous return and retrograde venous blood flow (e.g., sexual activity, stress, Valsalva maneuver). 3 Unfortunately, definitive evidence supporting any of these mechanisms has been lacking. 3 Even a neuropsychological cause has been proposed. Various proponents have advocated ischemic, migrainous, and epileptic causes. What causes TGA? For years this question has been debated. There are no apparent long-term sequelae, and recurrence is uncommon. 1,2 ⇓ As quickly as the amnesic syndrome appears, it resolves, usually within 24 hours. Without warning, the patient suddenly experiences antegrade memory loss. Transient global amnesia (TGA) is a dramatic event.
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