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July 1994

Transient Unresponsiveness in the Elderly

Author Affiliations

Long Island Jewish Medical Center Long Island Campus for the Albert Einstein College of Medicine New Hyde Park, NY 11042

Arch Neurol. 1994;51(7):644. doi:10.1001/archneur.1994.00540190018007

We read with great interest the article by Haimovic and Beresford1 on transient unresponsiveness in the elderly. The importance of this previously undescribed entity cannot be overstressed. We would like to add our experience to emphasize its underrecognized occurrence and apparently benign prognosis. In a single month, there were three patients admitted to our institution for profound unresponsiveness in whom the full workup during the episode, including routine laboratory tests, toxicology screen, electrocardiogram, arterial blood gases, spinal tap, electroencephalogram, computed tomographic scans, and magnetic resonance imaging, revealed negative results. All three patients returned to baseline within 12 hours of admission. Two patients had recurrent episodes of total unresponsiveness, again returning to baseline within a few hours of each episode. The full workup, excluding spinal tap and magnetic resonance imaging, was repeated in both patients, again failing to explain the unresponsiveness. A repeated electroencephalogram done during the episode showed only

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