Usefulness of electroencephalograms in evaluating transient global amnesia
*Correspondencia: Dr. Fernando Cabrera Naranjo. Servicio de Neurología. Hospital Universitario Doctor Negrín. Barranco de la Ballena, s/n. E-35020 Las Palmas de Gran Canaria.
Fax: +34 928 449 107.
E-mail: fcabnar@hotmail.com
Introduction: Transient global amnesia (TGA) is a perfectly well defined clinical picture, but nevertheless even today its aetiology remains unknown. The three most widely accepted theories suggest it has a vascular origin, it is related with the pathophysiology of migraine or it is of an epileptiform nature.
Aim: To analyse whether there is an electroencephalographic pattern that is consistently repeated in a series of electro-encephalograms (EEG) carried out on patients with TGA.
Patients and methods: The study consists in a retrospective analysis of a sample of 345 patients referred to have an EEG after an episode of TGA.
Results: In almost 20% of the EEGs something that could be considered abnormal was found, although most of these findings (64%) were of little pathological significance. Of the remaining 26%, attention should be drawn to the cases of two patients with subclinical rhythmic electroencephalogram discharges of adults (a pattern with a meaning that is not altogether clear and which has previously been associated with TGA).
Conclusions: A considerable percentage of patients have TGA and EEG alterations, although most of them are of scarce pathological significance or can be attributed to some other underlying condition. We have not succeeded in identifying any pattern that is consistently repeated. Our results suggest that the EEG is a test with low diagnostic effectiveness in this pathology and it is necessary to reconsider the need to systematically perform such tests in suspected cases of TGA.
Objetivo Analizar si existe algún patrón electroencefalográfico que se repita de manera consistente en una serie de electroencefalogramas (EEG) de pacientes con AGT.
Pacientes y métodos Análisis retrospectivo de una muestra de 345 pacientes remitidos para la realización de EEG tras un episodio de AGT.
Resultados En casi el 20% de los EEG se encontró algún hallazgo fuera de la normalidad, si bien la mayor parte de ellos (64%) era de escaso significado patológico. Del 26% restante cabe destacar la presencia de dos pacientes con descargas electroencefalográficas rítmicas subclínicas del adulto (patrón de significado incierto que previamente ya se ha asociado con AGT).
Conclusiones Existe un porcentaje no despreciable de pacientes con AGT y alteraciones en el EEG, si bien la mayor parte de ellas es de escaso significado patológico o atribuible a otra patología de base. No hemos sido capaces de identificar ningún patrón que se repita de manera consistente. Nuestros resultados sugieren que el EEG es una prueba con bajo rendimiento diagnóstico en esta patología y que habría que plantearse la necesidad de realizarla sistemáticamente ante una AGT.