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Acute amnestic syndrome differential diagnosis (MRI)

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Transient global amnesia (A, B), Wernicke-Korsakoff syndrome (C, D), limbic encephalitis (E, F), and lymphoma (G, H) can present with acute anterograde amnesia, with or without other neurologic symptoms. Bilateral hippocampal punctate diffusion lesions in a case of transient global amnesia are shown in (A) fluid-attenuated inversion recovery (FLAIR) and (B) diffusion-weighted imaging (DWI). In alcoholic Wernicke-Korsakoff syndrome, tectal plate lesions are shown in FLAIR and DWI sequences (C, D). In paraneoplastic limbic encephalitis, MRI shows bilateral hyperintensity of the hippocampi on both FLAIR (E) and DWI (F) sequences. A CNS lymphoma involving the fornix, frontal lobes, and periventricular white matter is shown in (G) (FLAIR) and (H) (DWI), appearing as a diffuse hyperintense alteration on both sequences. (Source: Mazzacane F, Ferrari F, Malvaso A, et al. Acute amnestic syndrome in fornix lesions: a systematic review of reported cases with a focus on differential diagnosis. Front Neurol 2024;15:1338291. Creative Commons Attribution 4.0 International [CC BY 4.0] license, creativecommons.org/licenses/by/4.0.)