Document Detail

Transient ischemic attacks and inhibitory seizures in elderly patients.
MedLine Citation:
PMID:  19776589     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The new definition of a transient ischemic attack (TIA) makes it more difficult to distinguish it from an inhibitory seizure (IS). PURPOSE: The present study compares the characteristics of patients with an IS to those with a TIA, taking into account the old and the new definition of a TIA. PATIENTS AND METHODS: The clinical characteristics and the electroencephalogram (EEG) findings of 25 patients with an IS were compared to 252 patients with a TIA according to the old definition. Subgroups of 10 patients with an IS without structural lesions and 195 TIA patients according to the new definition were also analyzed. The differential diagnostic clues were examined. RESULTS: Differences in age, gender distribution and vascular risk factors were observed only when comparing the overall patient groups. However, these differences disappeared when the subgroups were analyzed. Temporary speech disturbance, associated with some partial amnesia for the event, was the most common clinical presentation of an IS. Additionally, specific and nonspecific postictal EEG abnormalities were observed in the majority of the IS patients, while the EEG was normal in more than 90% of the TIA patients. CONCLUSIONS: An IS must be suspected in a patient with a short temporary speech disturbance and partial amnesia for the event. In view of the new definition of a TIA, urgent EEG becomes mandatory in each patient with a brief episode of neurological dysfunction.
J De Reuck; G Van Maele
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Publication Detail:
Type:  Journal Article     Date:  2009-09-24
Journal Detail:
Title:  European neurology     Volume:  62     ISSN:  1421-9913     ISO Abbreviation:  Eur. Neurol.     Publication Date:  2009  
Date Detail:
Created Date:  2009-11-12     Completed Date:  2010-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0150760     Medline TA:  Eur Neurol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  344-8     Citation Subset:  IM    
Department of Neurology, University Hospital, Ghent, Belgium.
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MeSH Terms
Age Factors
Brain / physiopathology*,  radiography
Diagnosis, Differential
Epilepsy, Generalized / diagnosis*,  physiopathology
Ischemic Attack, Transient / diagnosis*,  physiopathology
Magnetic Resonance Imaging
Middle Aged
Risk Factors
Sex Factors
Statistics, Nonparametric
Comment In:
Eur Neurol. 2010;63(1):60-1   [PMID:  20029218 ]

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