Transient neurological attack

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Classification

Focal

For more information, see: Transient ischemic attack.

Nonfocal

Nonfocal transient neurological attack is defined as:[1][2]

"disturbances of vision in one or both eyes consisting of flashes, objects, distorted-view tunnel vision, or image moving on change of posture; alteration of muscle strength consisting of tiredness or heavy sensation in one or more limbs, either unilateral or bilateral; sensory symptoms alone (unilateral or bilateral) or a gradual spread of sensory symptoms; brain stem symptoms and coordination difficulties consisting of isolated disorder of swallowing or articulation, double vision, dizziness, or uncoordinated movements; and accompanying symptoms including unconsciousness, limb jerking, tingling of the limbs or lips, disorientation, and amnesia."

The most common symptoms are:[3]

Prognosis

In a cohort study of 6062 adults about 5% had a TNA over 10 years found rates of subsequent stroke and dementia were increased depending on type of transient neurological attack (see table).[3]

Rates of subsequent stroke and dementia after transient neurological attack[3]
  Stroke Dementia
Any Vascular
Focal attacks
(transient ischemic attacks)
2.14 0.94 1.12
Nonfocal attacks 1.56 1.59 4.97
Mixed attacks 2.48 3.46 18.8

Among nonfocal symptoms:

References

  1. Bots ML, van der Wilk EC, Koudstaal PJ, Hofman A, Grobbee DE (1997). "Transient neurological attacks in the general population. Prevalence, risk factors, and clinical relevance". Stroke 28 (4): 768–73. PMID 9099194[e]
  2. (1975) "A classification and outline of cerebrovascular diseases. II". Stroke 6 (5): 564–616. PMID 1179466[e]
  3. 3.0 3.1 3.2 Bos MJ, van Rijn MJ, Witteman JC, Hofman A, Koudstaal PJ, Breteler MM (2007). "Incidence and Prognosis of Transient Neurological Attacks". JAMA 298 (24): 2877–2885. DOI:10.1001/jama.298.24.2877. PMID 18159057. Research Blogging.
  4. 4.0 4.1 Evans JG (1990). "Transient neurological dysfunction and risk of stroke in an elderly English population: the different significance of vertigo and non-rotatory dizziness". Age Ageing 19 (1): 43–9. PMID 2316424[e]
  5. Dennis MS, Bamford JM, Sandercock PA, Warlow CP (1989). "Lone bilateral blindness: a transient ischaemic attack". Lancet 1 (8631): 185–8. DOI:10.1016/S0140-6736(89)91203-8. PMID 2563098. Research Blogging.
  6. Pessin MS, Kwan ES, DeWitt LD, Hedges TR, Gale D, Caplan LR (1987). "Posterior cerebral artery stenosis". Ann. Neurol. 21 (1): 85–9. DOI:10.1002/ana.410210115. PMID 3827217. Research Blogging.
  7. Gautier JC (1993). "Amaurosis fugax". N. Engl. J. Med. 329 (6): 426–8. PMID 8326979[e]
  8. Pantoni L, Bertini E, Lamassa M, Pracucci G, Inzitari D (2005). "Clinical features, risk factors, and prognosis in transient global amnesia: a follow-up study". Eur. J. Neurol. 12 (5): 350–6. DOI:10.1111/j.1468-1331.2004.00982.x. PMID 15804264. Research Blogging.
  9. Heyman A, Wilkinson W, Pfeffer R, Vogt T. 'Dizzy' spells in the elderly—a predictor of stroke? Tram Am Neurol Assoc 1980; 105:169-71.