P11 Unusual case of transient epileptic amnesia

Abstract

Introduction This case report of Transient Epileptic Amnesia (TEA) is presented due to the prolonged nature of the amnestic episodes, the significant delay to the correct diagnosis and the various diagnoses given to the patient in the meantime. Method Patient case presentation: Over a 34-month period a 62-year-old woman was seen in three different health settings before a correct diagnosis was provided. She experienced a total of nine episodes of transient amnesia (frequency: every 3–4 months; duration: 10 days; precipitant: stress and fatigue; occurrence: on waking from a “deep sleep”; precedent: gustatory hallucination; memory disturbance: partial anterograde amnesia, and retrograde amnesia for past events). Over the 3 years, she was given the following diagnoses by different clinicians of Transient Global Amnesia (TGA), Psychogenic Amnesia and then TEA. Following this, she received treatment with anti-epileptic drugs, which terminated any further episodes. Discussion Attacks usually last between 20 min to 60 min. However, in this case it was 10 days, which may be due to ongoing seizure activity or persistent post-ictal dysfunction of memory related brain structures. It took up to three times longer than the median time to diagnosis of 12 months for the correct diagnosis to be made. This may be due to the investigations being carried out inter-ictally, and the standard neuropsychological tests lacking sufficient sensitive to identify subtle memory disturbances. Conclusion The importance of correctly diagnosing the condition are: (1) Effective treatment. (2) Under-diagnosed. (3) Patients are always distressed by them, fearing the onset of dementia.