A diagnostic investigation would then probably focus on some form of undetected ischemic attack or cranial bleed. How might this improve emergency medicine practice? Once there, they lose track of their conversations, and an examining physician may require reintroduction several times during the visit. Seeing a once competent and healthy partner, sibling or parent become incapable of remembering what was said only a minute ago is very distressing, and hence it is often the relatives who will require reassurance. The pain was localized to his left flank with no alleviating or exacerbating factors, and he described it as a sharp sensation with radiation to the left inguinal region. There are anterograde and retrograde components to the amnesia.
Implicit learning in transient global amnesia and the role of stress. After recovery, the patient retains an amnesia for the period of the transient global amnesia and often for a few hours preceding it. Among older adults — over 50 years — cases jump to 23. She was unable to give a history of what had happened to her, but her husband reported that she had appeared distressed and was repeatedly asking the same question. A case-control study of 114 cases with prospective follow-up. Formal neuropsychometric testing revealed aphasia with marked deficit in auditory comprehension, word finding impairment and semantic paraphasias.
Initially, he would misuse words that apparently were similar for words within the same category. Rosen, in , 2007 Transient Global Amnesia Transient global amnesia is a relatively rare syndrome characterized by a sudden onset of severe anterograde amnesia and confusion that often includes repetitive questioning. Six months prior to presentation he had another episode of amnesia lasting 6 hours. In the case presented, the episode was witnessed with noted anterograde amnesia and a clear distinct precipitating event. Motor exam was notable for mild ataxia only.
The leading hypotheses are some form of epileptic event, a problem with blood circulation around, to or from the brain, or some kind of migraine-like phenomenon. There is evidence that the disorder results from reversible medial temporal lobe dysfunction, but the aetiology is uncertain. The first episode started while he was using a chain saw nine years prior to presentation with a second episode occurring shortly afterwards. Ten years prior to presentation the patient had an episode of amnestic confusion and was diagnosed with transient global amnesia. Genetic and Rare Diseases Information Center. In addition to the inability to form new memories anterograde , there is often some degree of retrograde amnesia, meaning an inability to remember things that have occurred in the past, reaching back anywhere from hours to, rarely, years.
There appears to be a link between transient global amnesia and a history of migraines, though the underlying factors that contribute to both conditions aren't fully understood. When asked to give the year or the month, the patient was unable to do so. Although speech and language characteristics had features of logopenic and semantic dementia, the finding of poor repetition, poor naming which benefitted from phonetic cueing in the presence of lateral temporal, parietal hypometabolism, her classification was most consistent with the logopenic variant of primary progressive aphasia. Symptoms Transient global amnesia is identified by its main symptom, which is the inability to form new memories and to recall the recent past. Successful prophylaxis of recurrent transient global amnesia with metoprolol. Attacks recur in less than 25% of patients, and fewer than 5% have more than three attacks.
The differential diagnosis includes seizures arising from the mesial temporal lobe. This episode is sometimes preceded by headache or nausea, a stressful life event, a medical procedure, intense emotion, or vigorous exercise, and an episode of migraine may be a precipitating factor. A sudden temporary episode of memory loss and confusion is called transient global amnesia. He had over 20 years of formal education. Once an attack is over, patients regain some memory around the event but remain amnesic for the central period of the episode.
Typically, patients will not be able to remember events for the past few hours, and not be able to retain new information for more than a few minutes. Causes The underlying cause of transient global amnesia is unknown. Full recovery is the norm, but without memory of the amnesic period. This condition is rare and is generally considered harmless and unlikely to reoccur after the first incident. There is no evidence to support an epileptic etiology or transient arterial ischemic events.
There was evidence of loss of word meaning. The condition most often affects people in middle or older age. Usually the anterograde amnesia is more profound, has a greater duration, causes the greater disability and creates more distress than the retrograde amnesia. There is usually, but not always, a history of provoking factors; these can include one or more of the following: vigorous exercise, acute emotional stress, or change in temperature. Bucuk M, Muzur A, Willheim K, et al. Acta Neurol Scand 1990; 81:358.
Further research needs to be done to elucidate this relationship. In addition, you may not remember anything about what's happening in the here and now. Credit may be claimed for one year from the date of each issue. Case—control study of 24 cases. Transient global amnesia: clinical characteristics and prognosis.
The differences are sufficiently meaningful that transient amnesia may be considered a heterogeneous clinical syndrome with multiple etiologies, corresponding mechanisms, and differing prognoses. Complications Transient global amnesia has no direct complications. The neurologist consulted obtained a thorough history and examined the patient. Journal of Neurology, Neurosurgery, and Psychiatry. Episodes tend to be short-lived, lasting only a couple of hours, with memory being fully intact once regained. Transient amnesia: epileptic or global? Fortunately, this condition resolves on its own, typically within hours of onset.