Transient global amnesia and functional retrograde amnesia: contrasting examples of episodic memory loss

We studied 11 patients with transient global amnesia (TGA) and 10 patients with functional retrograde amnesia (FRA). Patients with TGA had a uniform clinical picture: a severe, relatively isolated amnesic syndrome that started suddenly, persisted for 4−12 h, and then gradually improved to essentially normal over the next 12−24 h. During the episode, the patients had severe anterograde amnesia for verbal and non-verbal material and retrograde amnesia that typically covered at least two decades. Thirty hours to 42 days after the episode, the patients had recovered completely and performed normally on tests of anterograde and retrograde amnesia. By contrast, patients with FRA had a sudden onset of memory problems that were characterized by severe retrograde amnesia without associated anterograde amnesia and with a clinical presentation that otherwise varied considerably. The episodes persisted from several weeks to more than two years, and some of the patients had not recovered at the time of our last contact with them. The uniform clinical picture of TGA and the variable clinical picture of FRA presumably reflect their respective neurologic (‘organic’) and psychogenic (‘non-organic’) aetiologies.

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097 A rare case of recurrent transient global amnesia

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-anzan.96 ◽

2018 ◽

Vol 89 (6) ◽

pp. A38.3-A39

Author(s):

Sameer Saleem ◽

Ronak Patel ◽

Yash Gawarikar

Keyword(s):

Transient Global Amnesia ◽

Anterograde Amnesia ◽

Epileptic Activity ◽

Sudden Onset ◽

Clinical Syndrome ◽

Slice Thickness ◽

Diagnostic Dilemma ◽

Monthly Basis ◽

Neurology Clinic ◽

Global Amnesia

IntroductionTransient global amnesia (TGA) is a clinical syndrome characterised by the sudden onset of anterograde amnesia accompanied by repetitive questioning, sometimes with a retrograde component, lasting up to 24 hours, without compromise of other neurologic functions.CaseA 71 year old male presented to the neurology clinic with history of recurrent episodes of reversible anterograde amnesia with repetitive questioning. His first two episodes were in May 2016 and clinically very typical of TGA. After that he had recurrent episodes and he noted that they were happening on a monthly basis. He had an episode on 24 March 2017 at Yangon airport as he was returning from a trip to Myanmar. He had had three episodes in February 2017 and two in March and April 2017 and one episode on 20 May 2017. Initial MRI brain showed frontotemporal atrophy suggestive of Alzheimer’s disease and there was hypo-perfusion on the nuclear medicine study. EEG did not show any epileptic activity. His partner described a typical episode where the patient lost his memory for the preceding 24 hours and he had repetitive questioning such as ”what day is it” repeatedly. During the entire episode, he was conscious and able to converse appropriately. He had another episode of amnesia on 19 August and was admitted and underwent an MRI of brain, which showed characteristic punctate abnormalities in the bilateral hippocampi on B2000 DWI.ConclusionThe estimated annual rate of recurrence of TGA is 5.8%. Diagnosis is made from typical clinical features and typical MRI DWI findings of punctate lesions in the hippocampal with a DWI resolution of B=2000, and a thin slice thickness of 2 to 3 mm. Our patient had 11 documented episodes of transient amnesia and was a diagnostic dilemma until the characteristic hippocampal abnormalities were demonstrated on MRI.

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Transient global amnesia: an uncommon presentation of acute myocardial infarction

Italian Journal of Medicine ◽

10.4081/itjm.2018.945 ◽

2018 ◽

Vol 12 (2) ◽

pp. 148

Author(s):

Paolo Tirelli ◽

Fulvio Cacciapuoti ◽

Filomena Scarano ◽

Federico Cacciapuoti

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Rare Case ◽

Memory Loss ◽

Transient Global Amnesia ◽

Sudden Onset ◽

Sympathetic Hyperactivity ◽

Uncommon Presentation ◽

Temporal Structures ◽

Global Amnesia

Transient global amnesia (TGA) is an acute neurological syndrome characterized by sudden-onset global (anterograde and retrograde) amnesia, without compromising other neurological functions. This clinical condition lasts up to 24 h with whole restoration. Several causes have been proposed as responsible for it. Among these, acute myocardial infarction (AMI) was reported as a rare cause of TGA. Sympathetic hyperactivity occurring too early in AMI seems to induce vasospasm, responsible for venous cerebral congestion acting on hippocampal and temporal structures and consequent memory loss. A rare case of TGA as precocious display of subsequent AMI was described.

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Transient global amnesia following transoesophageal echocardiography

BMJ Case Reports ◽

10.1136/bcr-2020-234751 ◽

2020 ◽

Vol 13 (4) ◽

pp. e234751

Author(s):

Mark Philip Cassar ◽

Katrin Balkhausen

Keyword(s):

Septal Defect ◽

Transient Global Amnesia ◽

Anterograde Amnesia ◽

Transoesophageal Echocardiography ◽

Sudden Onset ◽

Clinical Suspicion ◽

Secundum Atrial Septal Defect ◽

Global Amnesia ◽

The Right ◽

The Brain

Transient global amnesia (TGA) is characterised by the sudden onset of isolated anterograde amnesia, which resolves within 24 hours. Here, we discuss the case of a 63-year-old woman who underwent a transoesophageal echocardiogram (TOE) as part of her workup for pulmonary hypertension. She was well on the morning of the procedure, and following consent, underwent transoesophageal echocardiography without sedation. The procedure was uncomplicated with normal observations throughout, confirming a suspected secundum atrial septal defect. Immediately following oesophageal extubation, it was noted that the patient was disoriented. The physical neurological examination was unremarkable. Urgent MRI of the brain showed normal anatomy; a diagnosis of TGA was made. Within 10 hours of onset, the patient was back to her baseline. Isolated anterograde amnesia following transoesophageal echocardiography should raise the clinical suspicion of TGA. Prompt clinical examination and support from other specialties are paramount in making the right diagnosis.

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Transient global amnesia

Reviews in Clinical Gerontology ◽

10.1017/s0959259813000063 ◽

2013 ◽

Vol 23 (3) ◽

pp. 189-195

Author(s):

P Boovalingam ◽

N Shah

Keyword(s):

Medical Imaging ◽

Retrograde Amnesia ◽

19Th Century ◽

Clinical Features ◽

Transient Global Amnesia ◽

Global Amnesia ◽

The 19Th Century

SummaryTransient global amnesia (TGA) has been described since the 19th century. It is characterized by an episode of anterograde and retrograde amnesia lasting less than 24 hours. During this episode patients are conscious and able to interact normally, but are typically distressed and repeat questions without remembering explanations. Despite progress in medical imaging, no cause for the condition has been proven. Prognosis is excellent and management centres on recognition and reassurance. We describe the epidemiology, pathophysiology, clinical features and management.

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Transient Global Amnesia Associated with an Acute Infarction at the Cingulate Gyrus

Case Reports in Neurological Medicine ◽

10.1155/2014/418180 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Alejandro Gallardo-Tur ◽

Jorge Romero-Godoy ◽

Carlos de la Cruz Cosme ◽

Adriá Arboix

Keyword(s):

Limbic System ◽

Short Term Memory ◽

Memory Loss ◽

Brain Magnetic Resonance Imaging ◽

Transient Global Amnesia ◽

Cingulate Gyrus ◽

Clinical Disorder ◽

Acute Infarction ◽

Maximal Diameter ◽

Global Amnesia

Background. Transient global amnesia (TGA) is a syndrome of sudden, unexplained isolated short-term memory loss. In the majority of TGA cases, no causes can be identified and neuroimaging, CSF studies and EEG are usually normal. We present a patient with TGA associated with a small acute infarct at the cingulate gyrus.Case Report. The patient, a 62 year-old man, developed two episodes of TGA. He had hypertension and hypercholesterolemia. He was found to have an acute ischemic stroke of small size (15 mm of maximal diameter) at the right cerebral cingulate gyrus diagnosed on brain magnetic resonance imaging. No lesions involving other limbic system structures such as thalamus, fornix, corpus callosum, or hippocampal structures were seen. The remainder of the examination was normal.Conclusion. Unilateral ischemic lesions of limbic system structures may result in TGA. We must bear in mind that TGA can be an associated clinical disorder of cingulate gyrus infarct.

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