Recurrent amnesia caused by early seizures after hippocampal infarction: A case report

TY - JOUR

T1 - Recurrent amnesia caused by early seizures after hippocampal infarction: A case report

AU - Schlemm, Eckhard

AU - Magnus, Tim

AU - Rimmele, Leander D

AU - Münsterberg, Justine

AU - Bester, Maxim

AU - Kessner, Simon S

AU - Gelderblom, Mathias

AU - Gerloff, Christian

N1 - © 2022. The Author(s).

PY - 2022/1/10

Y1 - 2022/1/10

N2 - BACKGROUND: We report the case of a patient with recurrent episodes of disturbed memory suggestive of transient epileptic amnesia, and a focal hippocampal lesion typically associated with transient global amnesia. We argue how careful consideration of clinical, electrophysiological and imaging findings can resolve this apparent contradiction and lead to a diagnosis of early symptomatic post-stroke seizures that links brain structure to function in a new, clinically relevant way.CASE PRESENTATION: A 70-year-old patient was identified in clinical practice in our tertiary care centre and was evaluated clinically as well as by repeated electroencephalography and magnetic resonance imaging. The presenting complaint were recurrent episodes of short-term memory disturbance which manifested as isolated anterograde amnesia on neurocognitive evaluation. EEG and MRI revealed predominantly right frontotemporal spikes and a punctate diffusion-restricted lesion in the left hippocampus, respectively. Both symptoms and EEG changes subsided under anticonvulsant treatment with levetiracetam.CONCLUSIONS: Our report contributes to the current discussion of clinical challenges in the differential diagnosis of transient memory disturbance. It suggests that focal diffusion-restricted hippocampal lesions, as seen in TGA, might be ischemic and thus highlights the importance of considering post-stroke seizures as a possible cause of transient memory disturbance.

AB - BACKGROUND: We report the case of a patient with recurrent episodes of disturbed memory suggestive of transient epileptic amnesia, and a focal hippocampal lesion typically associated with transient global amnesia. We argue how careful consideration of clinical, electrophysiological and imaging findings can resolve this apparent contradiction and lead to a diagnosis of early symptomatic post-stroke seizures that links brain structure to function in a new, clinically relevant way.CASE PRESENTATION: A 70-year-old patient was identified in clinical practice in our tertiary care centre and was evaluated clinically as well as by repeated electroencephalography and magnetic resonance imaging. The presenting complaint were recurrent episodes of short-term memory disturbance which manifested as isolated anterograde amnesia on neurocognitive evaluation. EEG and MRI revealed predominantly right frontotemporal spikes and a punctate diffusion-restricted lesion in the left hippocampus, respectively. Both symptoms and EEG changes subsided under anticonvulsant treatment with levetiracetam.CONCLUSIONS: Our report contributes to the current discussion of clinical challenges in the differential diagnosis of transient memory disturbance. It suggests that focal diffusion-restricted hippocampal lesions, as seen in TGA, might be ischemic and thus highlights the importance of considering post-stroke seizures as a possible cause of transient memory disturbance.

U2 - 10.1186/s12883-021-02543-8

DO - 10.1186/s12883-021-02543-8

M3 - SCORING: Journal article

C2 - 35012472

VL - 22

JO - BMC NEUROL

JF - BMC NEUROL

SN - 1471-2377

IS - 1

M1 - 18

ER -