Long-term sequelae of transient global amnesia: A systematic review and meta-analysis

Though largely regarded as benign, the frightening experience of transient global amnesia (TGA) raises concerns over recurrence and long-term impact for patients. We aim to provide a comprehensive systematic review and meta-analysis of the long-term sequelae of TGA regarding recurrence, cognitive, neurological and neuropsychiatric complications.

PubMed, Embase, Scopus, Cochrane, WHO ICTRP, and ClinicalTrials.gov were searched from January 1, 2000 to January 31, 2026. Eligible studies assessed recurrence, stroke, seizure/epilepsy, cognitive and neuropsychiatric outcomes post-TGA. Random-effects meta-analysis of proportions was done for recurrence, stroke and seizure/epilepsy. Lack of standardised control arms prevented relative risk analysis.

In 14 cohort studies (n = 3365), the pooled proportion of recurrence post-TGA was 8% (95% CI, 5-12%; I² 84.6%). GRADE certainty was 'very low'. For stroke occurrence post-TGA, 4 studies (n = 852) showed a pooled proportion of 3% (95% Cl, 2-6%; I²=42.1%). GRADE certainty was 'low'. For seizure/epilepsy post-TGA, 4 studies (n²=964) provided a pooled proportion of 1% (95% Cl, 0-4%; I² = 36.7%). GRADE certainty was 'very low'. Qualitative synthesis finds, in a small and heterogeneous dataset, a favourable prognostic profile regarding cognitive and neuropsychiatric sequelae with transient effects resolving on long-term follow-up.

This meta-analysis finds that TGA has a reassuring pattern of complications. However, the low certainty of evidence indicates the current evidence base is insufficient to draw strong conclusions. Patients should be informed of low pooled proportions, but clinician advice should be tailored to individual significance of complications.

PROSPERO ID CRD420261304248.