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. Patients are often disoriented in regard to time and place but usually not personal identity. The confusion may simply reflect a response to the amnesia (e.g., if an amnesic patient asks what is wrong with his or her memory or what the date is, he will forget any answer provided within moments). The absence of such overt confusion and repetitive questioning in chronic amnesia patients may reflect an eventual accommodation of the patient to the amnesic state. Transient global amnesia typically lasts for hours, although its duration may range from minutes to days. Retrograde amnesia is also common, although its severity varies much more than that of anterograde amnesia. Retrograde amnesia is usually extensive and is temporally graded. As the anterograde amnesia gradually resolves, the temporal extent of the retrograde amnesia appears to shrink. After recovery, the patient retains an amnesia for the period of the transient global amnesia and often for a few hours preceding it.y Transient global amnesia is often associated with atherosclerotic disease, especially ischemia

in the posterior circulation, but seizure activity and migraine attacks have also been posited as a mechanism in some cases. In patients with this syndrome, an EEG may show abnormalities, although in most cases the findings are nonspecific. Attacks recur in less than 25 percent of patients, and fewer than 5 percent have more than three. The frequency of seizures or subsequent strokes is no different from that in a comparable age-matched population. No special treatment is indicated for these unusual cases of transient but traumatic memory impairment.

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