The article by Dr Louis Caplan1 raises both interesting and disturbing questions. I suspect that this concept is a return to the old, discredited diagnosis, cerebrovascular insufficiency. Undoubtedly, many of these patients given this diagnosis may have had transient ischemic attacks. In elderly patients, however, other diagnoses are quite common; yet the history is obscured by vague recollections, poor vocabulary, and inadequate self-expression. Persistent prompting is usually required.
Alpert JN. Funny Turns. Arch Neurol. 2008;65(11):1548. doi:10.1001/archneur.65.11.1548-b
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