Le syndrome of transient epileptic amnesia et l'epileptic amnesic syndrome sont-ils une même entité ?

A chronic subjective cognitive impairment can be symptomatic of temporal lobe epilepsy (TLE); it is thereby frequently reversible with the use of antiepileptic monotherapy. In this field, two distinct syndromes have been described: the Epileptic Amnesic Syndrome (EAS) and the Syndrome of Transient Epileptic Amnesia. Their diagnostic criteria have much in common but identification of STEA is based only on transient amnesic attacks. On the contrary, EAS takes into account subtle temporal lobe seizures. Here, we report a case where chronic cognitive disturbances were combined with very limited temporal lobe seizures while amnesic attacks were lacking. Antiepileptic drug treatment led to normalization of cognitive function. The criteria of STEA were not applicable because of the lack of transient amnesia in the patients' medical history. Considering brief episodes of flashbacks and abdominal pain as possibly seizure-related, the criteria of EAS were more operative: they allowed proper investigation to confirm TLE in our patient.