In the assessment of patients with transient attacks of neurological dysfunction, a distinction is often made between attacks characterized by focal symptoms (transient ischemic attacks [TIAs]) and attacks characterized by diffuse, nonlocalizing symptoms—often considered more benign than TIAs. In an analysis of data from 6062 participants in a prospective population-based cohort study of chronic disease in Rotterdam, the Netherlands, Bos and colleagues Article assessed the incidence and prognosis of transient neurological attacks (TNAs),
a category that included focal transient neurological dysfunction (focal TNAs or TIAs), nonfocal TNAs, and mixed focal and nonfocal TNAs. The authors report that during 60 535 person-years of follow-up,
a TNA occurred in 548 participants (282 focal, 228 nonfocal, and 38
mixed). Among the authors' findings were that persons with focal TNAs had a higher risk of stroke, and persons with nonfocal TNAs a higher risk of stroke and dementia compared with persons without TNAs. In an editorial, Johnston Article discusses the utility of TNA as a broad diagnostic category and considers the implications of the reported findings for the evaluation of patients with nonfocal neurological symptoms.