Remember this Diagnosis

  1. FYI. A teacher where I work had many of the symptoms listed here. A local physician thought it was exercise induced hypoglycemia but it just didn't figure with me. This fits his condition like a glove and often happens after a heavy workout with weights or jumping up and down screaming at sports events!

    Transient global amnesia: A passing episode of short-term memory loss without other signs or symptoms of neurological impairment. In transient global ]amnesia (TGA) the individual does not lose consciousness but does lose the ability to form new lasting memories.

    Motor function is not affected. The individual may be disoriented to place and time, may recognize that something is wrong, and may become distressed at this realization. The average age of patients with TGA is 62 (range: 47-80) and the mean duration of the episode is 5.7 hours, with a range of 20 minutes to 20 hours.
    The recommended criteria for the diagnosis of TGA are:
    • Attacks must be witnessed and information must be available from a capable observer.
    • Clear-cut anterograde amnesia must be present during the attack.
    • Clouding of consciousness and loss of personal identity must be absent and cognitive impairment must be limited to amnesia.
    • There must be no accompanying focal neurological symptoms or signs, and epileptic features must be absent.
    • Attacks must resolve within 24 hours.
    • Patients with a recent head injury or known active ]epilepsy are excluded.

    Patients with many other clinical _entities may present with amnesia and these may need to be ruled out before the diagnosis of TGA can be made. These conditions include alcoholic "blackouts," TIA transient ischemic attack), temporal lobe epilepsy, brain tumor, drug reactions, and intracerebral or subarachnoid hemorrhage.

    Background: Transient global amnesia (TGA) has been a well-described phenomenon for more than 40 years. Clinically, it manifests with a paroxysmal, transient loss of memory function. Immediate recall ability is preserved, as is remote memory; however, patients experience striking loss of memory for recent events and an impaired ability to retain new information. In some cases, the degree of retrograde memory loss is mild.

    Many patients are anxious or agitated and may repeatedly ask questions concerning transpiring events. On mental status examination, language function is preserved, which indicates a preservation of semantic and syntax memory. Attention is spared, visual-spatial skills are intact, and social skills are retained. Symptoms typically last less than 24 hours. As the syndrome resolves, the amnesia improves, but the patient may be left with a distinct lapse of recollection for events during the attack.

    • Precipitants of TGA frequently include physical exertion, overwhelming emotional stress, pain, cold-water exposure, sexual intercourse, and Valsalva maneuver. These triggers may have a common physiologic feature: increased venous return to the superior vena cava.

    Regardless of the etiology of TGA, it is universally felt to be a benign condition which requires no further treatment other than reassurance to the patient and their family. Indeed, no treatment has been shown to affect the recurrence of TGA. The patient should be told that while TGA, while obviously appearing to be threatening, is not a predecessor to a stroke or a tumor and that the recurrence rate of future amnesic events is low. This condition does not require suspension or canceling of a patient's drivers license or an extensive workup when the presentation meets the criteria for pure TGA.
    Last edit by zenman on Dec 12, '05
    •  
  2. 2 Comments

  3. by   athena55
    Hi, I am new to AllNurses.com.
    Thank you, Sir, for this information. With your permission, may I print it out? Also, do ya have any references off the top of your head (I don't have my texts with me, sigh, and it is too cold to go to the library, but I can do a search [as long as this bloody computer doesn't quit on me])
    Thank you in advance
  4. by   zenman
    Quote from athena55
    Hi, I am new to AllNurses.com.
    Thank you, Sir, for this information. With your permission, may I print it out? Also, do ya have any references off the top of your head (I don't have my texts with me, sigh, and it is too cold to go to the library, but I can do a search [as long as this bloody computer doesn't quit on me])
    Thank you in advance
    Well, heck, I forgot to add the reference! It was at http://www.medicinenet.com/script/main/hp.asp

close