Transient amnesia: epileptic or global? A differential diagnosis with significant implications for management.
A 58-year-old lady presented to her local district general hospital with confusion. She was unable to give a history of what had happened to her, but her husband reported that she had appeared distressed and was repeatedly asking the same question. She could not remember where she had been on holiday the week before, or whether her mother was alive or dead. The episode settled spontaneously after ∼6 h. The patient had no subsequent recollection of this period. She was otherwise in good health, with a history of only infrequent migraine. She admitted being under recent stress preparing for her son's wedding. Her general and neurological examinations at presentation were normal. Computed tomography brain scan was normal. A provisional diagnosis of transient ischaemic attack was made by the local stroke coordinator, but the managing clinician was uncertain as to whether the episode may have been an epileptic seizure, so arrangements were made for an outpatient electroencephalography (EEG) a few weeks later. The patient was advised not to drive in the …