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Is Transient Global Amnesia Linked To Dementia

What Triggers Transient Global Amnesia

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The cause of transient global amnesia is unknown. People older than 50 are more likely to experience TGA. Research suggests there also may be a link between patients who have a history of migraines and those who experience TGA. In most cases, there is no activity that triggers a transient global amnesia episode.

Is Transient Global Amnesia Related To Alzheimer’s

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Background: Transient global amnesia is a clinical syndrome characterized by the sudden onset of larger anterograde and milder retrograde amnesia that lasts up to 24 h. The yearly incidence of dementia was compared in TGA and non-TGA cohorts. The cumulative hazard ratio of dementia was estimated.

One may also ask, which type of amnesia is Alzheimer’s linked to? Anterograde amnesia is memory loss that is present for events that occur or information that is presented after a brain injury or a disease develops. The ability to make new memories is impaired in anterograde amnesia.

Beside this, what can cause transient global amnesia?

Transient global amnesia is a sudden, temporary loss of memory for events during, after, and sometimes before the event that caused the amnesia. What causes many cases of transient global amnesia is not known, but one type is caused by drinking too much alcohol or taking certain drugs.

How rare is transient global amnesia?

Transient global amnesia occurs in approximately 3 to 10 people out of every 100,000.

Classification Of Tga Using Multivariate Analysis Techniques

The discrepancies between neuroimaging studies suggest that there might be some heterogeneity in the pathophysiology of TGA. In an attempt to classify clinical and demographical features associated with TGA, we have carried out a multi-stage analysis procedure on the data collected on our 142 subjects by means of the multiple factorial analysis and the hierarchical cluster analysis . The MFA and the HCA provide a spatial representation of data that can facilitate interpretations and reveal relationships between subjects or variables. These methods, which were employed to carry out the overall classification, have been used in different fields, including neuropsychology .

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Ethics And Consent For Participation

Ethics approval was obtained from the Joondalup Health Campus Human Research Ethics Committee , endorsed by Ramsay Corporate Services JHC-HREC No. 2011/1018. All methods were performed in accordance with the relevant guidelines and regulations of the JHC-HREC. Written informed consent was obtained from all participants. Information obtained from participants was internally collated into a database and analysed by our biostatistician.

Ruling Out Other Causes

Disorders of higher mental function

Once I was in emergency, the tests started. Blood tests, a CT scan, an EEG test, balance tests, urine tests, speech tests. Any test possible to rule out a stroke, given my history.

Much later in the evening after the CT scan revealed no stroke activity, the on-call head nurse said to Lola, “I think your mother has had a TGA episode.”

A what? A transient global amnesia episode, commonly known as a TGA.

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Critical Appraisal Of The Literature

A PubMed literature search was performed using the search terms transient global amnesia as well as amnesia and emergency. The National Guideline Clearinghouse , and the Cochrane Database of Systematic Reviews were searched with the term amnesia this search yielded only mentions of amnesia in the context of differential diagnoses for stroke syndromes, but no guidelines, policies, or reviews focused primarily on amnesia were found. We also searched for guidelines released by the American College of Emergency Physicians and the American Academy of Neurology. There are no known published guidelines by these bodies related specifically to amnesia.

Transient Global Amnesia As The First Clinical Symptom For Malignant B

Atif Zafar

1Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

2Columbia University, New York City, NY, USA

3Aga Khan University Hospital, Karachi, Pakistan

4West Virginia University, Morgantown, WV, USA

Abstract

We present the case of an elderly male who was diagnosed with transient global amnesia , only tobe diagnosed with B-cell lymphoma with central nervous system involvement a few weeks later. This is the first ever case reported in literature with lymphoma presenting as TGA. Literature review and pertinent points regarding high-yield imaging protocol for presumed TGA patients are discussed.

1. Case Report

We present an interesting case of a 70-year-old right-handed male with past medical history significant for hypertension and paroxysmal atrial fibrillation who was brought to the Emergency Room after experiencing acute onset of confusion. He had been in his usual state of health when he went out to mow the lawn in the afternoon. An hour later, his wife found him staring at the lawn mower appearing confused. According to her, he repeatedly asked, How did I come here? and What is going on? He was able to identify his wife and family members and recognize his home. He did not report a fall, loss of consciousness, weakness, dysarthria, or facial droop. There was no evidence of incontinence or tongue bite at the time. His symptoms persisted for over two hours, prompting the ER visit.

2. Discussion

Conflict of Interests

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Difference Between Amnesia And Dementia

Amnesia vs Dementia

Both amnesia and dementia are conditions of brain function, but they are two different conditions. Amnesia is only memory loss while dementia features a global loss of higher brain functions. This article will talk in detail about amnesia and dementia and the differences between them, highlighting their clinical features, symptoms, causes, and also the treatment/care they require.

Amnesia

Amnesia is memory loss. Memory loss can be due to head injury, traumatic life experiences, and physical defects of the brain. First two reasons are commoner than the third. It is important to note that certain head injuries can result in physical brain defects. There are many types of amnesia.

Anterograde amnesia features the inability to retain new memories while formed memories are intact. Medial diencephalon and medial temporal lobe deals with new memory formation. Anterograde amnesia cannot be treated by drugs due to neuronal loss.

Retrograde amnesia features an inability to recall memories before the event. There is a time limit to retrograde amnesia. It is usually temporary. Post traumatic amnesia after severe head injury may be retrograde, anterograde or mixed.

Dissociative amnesia is psychological. Lacunar amnesia features loss of memory of a single event. Korsakoff amnesia results from chronic alcoholism.

Dementia

Rapidly progressive dementia is a type of dementia which does not take years to manifest itself but does so in mere months. .

Arterial Ischemia And Venous Congestion

Outcome in Patients With Transient Global Amnesia

There are many parallels between TGA and TIA, which support the arterial ischemia hypothesis. TGA and TIA are characterized by an abrupt onset of reversible loss of function occurring in patients within similar age group demographics. Reported mean age of onset is 6066 years for TGA and 6971 years for TIA, with modal onset, for both, over the age of 50 years. Despite these similarities, statistical analysis has reliably shown significantly reduced atherosclerotic risk factor profiles, including decreased prevalence of embolic heart disease, diabetes mellitus, hypertension, and carotid artery atherosclerotic disease, in patients with TGA in comparison to those with TIA. Population cohort data have also consistently indicated that a history of TGA does not put patients at a higher risk of cerebrovascular events, and in fact, recent studies suggest a more favorable prognosis for TGA patients compared to TIA patients in regard to risk of future cerebrovascular events. Even more, one retrospective analysis showed no heightened risk of future cerebrovascular event following a TGA event when compared with healthy matched controls, further refuting an atherosclerotic hypothesis.

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Beyond 24 Hours: Outcomes

According to the standard accepted criteria, deficits of TGA resolve within 24 hours. There has been considerable research dedicated to the cognitive profile of TGA patients following the resolution of acute-phase symptoms however, results have been mixed.

A 2009 meta-analysis examined data from 25 different studies and compared 374 TGA subjects to 760 control subjects in the following five domains: anterograde episode long-term memory, retrograde episode long-term memory, short-term memory, semantic memory, and executive function. Beyond the first 24 hours, there was no significant difference between patients and controls in any of the five domains for the 30-day period following TGA onset. Similarly, a study with a median follow-up period of 1,128 days found no significant difference in performance between TGA patients and controls on tasks of episodic memory, semantic memory, working memory, executive functions, and attention. Alternatively, one study with follow-up periods of 4 months and 1 year found deficits in anterograde memory in TGA subjects when compared with controls however, only when data from both follow-up periods were pooled together. Additionally, at the 4-month follow-up visit, higher scores on anxiety and depression scales correlated with worse performance on tests of retrograde and anterograde memory tests, respectively.

How Is Amnesia Treated

To treat amnesia, your doctor will focus on the underlying cause of your condition.

Chemically induced amnesia, from alcohol for example, can be resolved through detoxification. Once the drug is out of your system, your memory problems will probably subside.

Amnesia from mild head trauma usually resolves without treatment over time. Amnesia from severe head injury may not recede. However, improvements usually occur within six to nine months.

Amnesia from dementia is often incurable. However, your doctor may prescribe medications to support learning and memory.

If you have persistent memory loss, your doctor may recommend occupational therapy. This type of therapy can help you learn new information and memory skills for daily living. Your therapist can also teach you how to use memory aids and techniques for organizing information to make it easier to retrieve.

The following healthy habits can lower your risk of blackouts, head injuries, dementia, stroke, and other potential causes of memory loss:

  • Avoid heavy use of alcohol or drugs.
  • Use protective headgear when youre playing sports that put you at high risk of concussion.
  • Stay mentally active throughout your life. For instance, take classes, explore new places, read new books, and play mentally challenging games.
  • Stay physically active throughout your life.
  • Eat a heart-healthy diet, including fruits, vegetables, whole grains, and low-fat proteins.
  • Stay hydrated.

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Could It Happen Again

Next morning, day three of my captivity, the professor of neurology swept by with an entourage of well-dressed neophytes in tow.

When he stopped at my bed, I seized the opportunity to ask some questions.

“Will this happen to me again?”

“It can, but not likely,” he said. “It only reoccurs in 4 per cent of cases.”

“I’ve read on the Mayo Clinic website that a TGA episode can be triggered by sexual intercourse. Is that true?”

What Causes Transient Global Amnesia

Dementia And Memory Disturbances

The exact cause of transient global amnesia is unknown. However, some research suggests that TGA results from lack of sufficient blood flow or oxygen flow to the brain. In some cases, TGA may be related to seizure activity in the brain.

Migraine headache appears to be a risk factor for developing TGA. Psychological factors, such as anxiety, may also make TGA more likely.

For some people, TGA may occur as a result of certain triggers or events, including:

  • Physical exertion
  • Sudden immersion in cold or hot water
  • Head trauma
  • Pain
  • Sexual intercourse
  • Performing the valsalva maneuver. This is a breathing technique purposely performed by a person as part of a medical test or to slow a rapid heart rate and other uses. It is performed by closing your mouth and pinching your nose and bearing down as if having a bowel movement.

One type of TGA results from excessive alcohol consumption, large doses of barbiturates, illicit street drugs or small doses of benzodiazepines.

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Study Of 142 Personal Cases

Between 1994 and 2004, we collected data on 142 patients . All were admitted to the emergency department of the Caen University Hospital and included after they had given informed consent to the study, which was done in line with the Declaration of Helsinski and approved by the local ethical committee.

Thirty-two of these patients failed to meet the first diagnostic criterion, because the onset of the episode had not been witnessed. A witness was, however, present for part of the attack. One patient had suffered head injury with loss of consciousness the previous year. Another patient began his amnesia after a mild closed head injury without loss of consciousness, but was nevertheless included, as his neurological examination was normal and he had suffered three typical TGA attacks several years earlier .

Table 1

In order to better understand the relationship between possible predisposing factors and TGA, we recruited a control group. This was made of twenty-one subjects who were gender- and age-matched to the study patients , and who were seen in the emergency department of the CHU for a variety of acute and transient medical conditions: transient ischaemic attack , attack of asthma, attack of angina, thoracic pain or fainting. After their consent was obtained, they filled in the same risk factor questionnaire as TGA patients .

Transient Global Amnesia Symptoms

People with transient global amnesia will usually keep repeating questions, such as Why am I here?, How did I get here? or What time is it?, as they cannot remember the answers. They often appear anxious, agitated and perplexed.

The ability to do learned activities, such as driving, is generally not affected. People also usually remember who they are and recognise people they know well.

Sometimes symptoms such as nausea, dizziness and headache occur with TGA.

People with TGA usually dont remember the episode afterwards. Understandably, this is a very frightening experience for both for the affected person and those around them.

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What Are The Symptoms Of Transient Global Amnesia

Transient global amnesia involves a sudden inability to form new memories. Some people also cannot recall memories from hours, days, or longer in the past.

People experiencing a TGA episode may appear disoriented and confused. They know who they are and know their friends and family members, but may repeat questions about the time or date. Other complex mental tasks, such as the ability to drive a car or cook, are not affected.

Other symptoms that can occur with TGA include:

  • Headache

Though Tga Is Relatively Rare Its Causes Remain Unknown And The Memories Lost During An Episode Can Never Be Recovered Jane E Brody Reports

‘Survivor’ Host Jeff Probst Reveals Transient Global Amnesia Diagnosis

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Late one morning in June, LJs husband got a distressed call from one of his wifes colleagues. Youd better come here right away, the colleague said. Your wife is acting weird. J, who had just returned from a doctor visit during which she underwent a minor painful procedure, kept asking her colleague for a password despite being told each time that there was none.

J, a 61-year-old arts administrator in New York who does not want her full name used, seemed physically OK, her colleague recalled. She knew who she was, she walked and talked properly, but what she said made no sense. Besides, J could remember nothing that happened after she left the doctors office and made her way to work. When J continued to behave oddly, the alarmed colleague called 911, and paramedics took her to Mount Sinai St Lukes Hospital.

The next thing J remembers is waking up hours later in a hospital bed and asking: Where am I? Why am I here? In the interim, Dr Carolyn Brockington, a vascular surgeon and director of the hospitals stroke unit, had examined her and ordered a CT scan and MRI of her brain. All the results were normal. There was no physical weakness, no structural abnormality, no evidence of a stroke, seizure or transient ischemic attack. So, what had happened?

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Transient Global Amnesia Causes & Consequences

Very worrying for those who suffer from it and those around it, transient global amnesia corresponds to a sudden loss of memory for a short time, less than 24 hours. This benign disorder, although spectacular, should always be followed by a medical visit.

Nicole, 71, was at the beach with her family when suddenly she became confused about what she was doing there. Have we been here for a long time? she asked repeatedly. Fearing the worse, her family members became highly concerned. After a visit to the nearest hospital emergency room, the reassuring verdict came: Nicole had suffered from transient global amnesia.

Diagnosis Of Transient Global Amnesia

  • A doctor’s evaluation

  • Imaging tests such as computed tomography and magnetic resonance imaging

Doctors usually diagnose transient global amnesia based mainly on symptoms. They also do tests to check for other causes of sudden amnesia:

  • Blood tests for alcohol and clotting disorders

  • Urine tests for illicit drugs

  • Brain imaging tests such as computed tomography or magnetic resonance imaging

When transient global amnesia first occurs, MRI does not show specific abnormalities. However, after a few days, MRI may show tiny dots in an area of the brain that is important in forming and retrieving memories . The spots may represent small areas where blood flow is decreased, suggesting a possible cause of the amnesia.

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What Is Transient Global Amnesia

Transient global amnesia is a rare medical condition in which a person experiences a sudden episode of memory loss. During a TGA episode, a person cannot form new memories and has difficulty recalling recent memories . Transient means passing, and TGA episodes usually last no more than several hours. In rare cases, TGA lasts up to 24 hours.

People with TGA remember who they are and can remember their friends and family members. They can still perform complex daily tasks, such as cooking or driving. They also retain their language and social interaction skills. However, during a TGA episode, they may not know where they are or the day or time.

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