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Table 66.3

Causes of Transient Neurological or Monocular Visual Symptoms

CauseComment
Migraine aura (with or without headache)

Stereotypical positive symptoms such tingling and visual symptoms, spreading over several minutes and typically resolving within 60 min.

Often positive family history for migraine.

Partial epileptic seizure

Positive symptoms (jerking or tingling, marching over several seconds).

May have impaired awareness (partial complex seizure).

Transient global amnesiaLoss of anterograde memory usually accompanied by repetitive questioning. Resolves usually within 6 h. No language deficit. Able to recognize surroundings and familiar individuals.
Metabolic

Hypoglycaemia: consider if recurrent events associated with low blood glucose.

See Chapter 81.

Structural lesion

For example brain tumour, chronic subdural haematoma.

See Chapter 72.

Demyelination

Subacute onset in young adults.

MRI clarifies diagnosis.

MononeuropathyLook for lower motor neuron signs.
Myasthenia gravisCheck for fatigability.
Monocular visual symptoms

Ocular or optic nerve disease.

See Chapter 19.