Transient global amnesia

Background

  • Paroxysmal, transient retrograde amnesia lasting several hours
  • Most common in female 40-60yo[1]

Clinical Features

  • Retrograde amnesia
  • Unaware of their memory loss
  • Normal attention and social skills
  • Periods of time typically less than 24 hrs, but typically lasts 4-6 hrs[2]
  • No localizing symptoms
    • If localizing symptoms, consider alternative diagnosis

Differential Diagnosis

Workup

Depending on presentation, consider CVA workup

  1. Bedside glucose
  2. Bedside hemoglobin (polycythemia)
  3. CBC
  4. Chemistry
  5. Coags
  6. Troponin
  7. ECG (esp A-fib)
  8. Head CT
    • Primarily used to exclude intracranial bleeding, abscess, tumor, other stroke mimics
  9. Also consider:
    • Pregnancy test
    • CXR (if infection suspected)
    • Urinalysis (if infection suspected)
    • Utox (if ingestion suspected)

Management

  • Rule out CVA (clinically or with further workup)
  • Neurology referral
  • Once diagnosed, no specific treatment needed[3]

Disposition

  • Discharge home with neurology follow up
  • Consider admission for equivocal cases

Prognosis

  • Full recovery with amnesia of event
  • Annual recurrence rate was 4.7%[4]

See Also

Stroke

External Links

References

  1. Lin KH, et al. Migraine is associated with a higher risk of transient global amnesia: a nationwide cohort study. Eur J Neurol. 2014; 21(5):718-24.
  2. Zeman AZ, et al..Transient global amnesia. Br J Hosp Med. 1997; 58:257-60.
  3. Owen D, et al. Classical diseases revisited: transient global amnesia. Postgrad Med J. 2007; 83(978):236–239.
  4. Hinge HH, et al. The prognosis of transient global amnesia. Results of a multicenter study. Arch Neurol. 1986; 43(7):673-6.