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Neurologist, epileptologist

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Transient global amnesia: causes, symptoms, diagnosis, treatment

Alexey Portnov, medical expert
Last reviewed: 20.11.2021

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Transient global amnesia is a memory disorder caused by central vascular or ischemic lesions. The diagnosis is made on the basis of clinical symptoms, laboratory results, CT and MRI (for evaluation of cerebral circulation). Amnesia is usually resolved on its own, but can recur. Specific treatment of transient global amnesia is not developed, the main disease is treated.

Transient global amnesia most often develops on the background of transient ischemia (due to atherosclerosis, thrombosis, thromboembolism), which causes bilateral disturbance of the posterior-medial thalamus or hippocampus function, but can develop after an epileptic fit or migraine attack.

Short-term amnesia on current events can occur after taking alcohol, high doses of barbiturates, low doses of benzodiazepines (midazolam and triazolam) and some other prohibited drugs.

Symptoms of transient global amnesia

During the attack, there is a complete disorientation, which lasts from 30-60 minutes to 12 hours or more, in combination with retrograde amnesia, which sometimes spreads over the events of the last few years. The orientation in time and space is lost, but the orientation in the self remains. Patients are usually restless and nervous, constantly trying to figure out what happened. At the same time, speech function, attention, visual-spatial and social skills are preserved. Disorders regress as the disease progresses backward. Relapses are unlikely, except for cases caused by convulsions and migraine.

Transitional amnesia after alcohol and central drugs is distinguished by selective retrograde character (loss of events before and during the administration of the drug), absence of confusion (during resolution of acute intoxication) and the probability of relapse only after repeated intake of the same amounts of the drug.

The diagnosis is made on the basis of clinical symptoms. Neurological examination, as a rule, does not reveal any abnormalities, except for amnesia.

Prognosis and treatment of transient global amnesia

The forecast is favorable. Symptoms usually resolve within 24 hours. When resolving the symptoms of the disease, the phenomena of amnesia disappear, but the memory for events during an attack can be lost. The frequency of recurrences during life varies from 5 to 25%.

It is recommended to exclude cerebral ischemia (stroke, thrombosis or thromboembolism) with CT or MRI (with or without angiography). The list of laboratory tests includes a general blood test, determination of coagulation parameters. EEG is only indicated if there is a suspicion of epilepsy.

Specific treatment is not developed. The main disease should be treated: ischemia or epilepsy.

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