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Transient global amnesia

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VOL: 100, ISSUE: 27, PAGE NO: 33

What is it?

- Transient global amnesia (TGA) is a temporary and isolated disorder of the memory.

- An episode of this disorder consists of a loss of recent and new memories.

- An episode of TGA usually occurs spontaneously.

- The syndrome is largely benign in nature due to the fact that the episode is temporary.

- The patient is usually otherwise healthy and middle aged or older.

- An attack may last several hours.


- TGA was first described in 1956 by Morris Bender.

- Since then, TGA has become a well-explained syndrome but its cause is still not totally understood.

- TGA affects memory function. 

Although many mechanisms have been proposed, no single cause can fully explain all the features of TGA.

- Some authors have stated that patients with TGA have age and risk factor profiles similar to those of patients who experience stroke or transient ischaemic attack (TIA).


Precipitating factors include:

- Sexual intercourse;

- Heavy physical exercise (usually swimming in cold water);

- There is a small correlation between TGA and patients who suffer from migraines, epileptic fits, and cerebrovascular disease;

- Physical or emotional stress;

- Driving a car.


- The precise pathophysiology of TGA is not clear.

- Blood flow to specific brain areas that involve memory including the thalamus and/or mesial temporal structures appears to be disrupted transiently during TGA.


- Three people per 100,000 of the population per year are affected with TGA.

- The condition affects 50 per cent more men than women.

- Less than 25 per cent of patients experience repeated episodes. 

- Less than three per cent of patients experience three or more episodes.

- Permanent memory loss is rare.


A patient with TGA:

- Is acutely confused;

- Is neurologically intact except for absent memory (for example, remains alert, remembers identity, remembers past experiences); 

- Asks relevant questions repeatedly because she or he does not remember the answer;

- Is unable to recall the episode once she or he has recovered;

- Usually maintains her or his semantic memory (long-term memory responsible for retaining knowledge about the world, including the meaning of words and objects) and meta memory (the awareness of what one should know);

- Anterograde amnesia must be present.


- There is no treatment.

- TGA is short-lived.

- Patients with recurrent episodes usually do not experience any increased morbidity. 

Differential diagnosis

- Toxin-induced memory loss tends to include inattention and an inability to sustain coherent thought.

- In complex partial seizures, repetitive questioning is not a feature.

- Psychogenic amnesia tends to occur at a younger age and the patient is more likely to have personality changes and not remember personal details. 


Transient Global Amnesia (GP notes):

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