eMedicine Specialties > Neurology > Neuro-vascular Diseases

Transient Global Amnesia: Follow-up

Author: Roy Sucholeiki, MD, Director, Comprehensive Seizure and Epilepsy Program, The Neurosciences Institute at Central DuPage Hospital
Contributor Information and Disclosures

Updated: Dec 3, 2008

Miscellaneous

Medicolegal Pitfalls

  • Remember that stroke is in the differential diagnosis of transient global amnesia, especially if presenting within 24 hours of symptom onset.
    • Strokes, particularly in the distribution of the posterior cerebral circulation, can present with an amnestic state.
    • Stroke should be ruled out in the initial workup.
    • Look for risk factors and treat accordingly. For example, smoking, hypercholesterolemia, diabetes, and hypertension are all modifiable risk factors.
  • If seizures are a consideration, then perform appropriate workup, including EEG and MRI of the brain. Treatment with an anticonvulsant depends on the outcome of this workup.
 


More on Transient Global Amnesia

Overview: Transient Global Amnesia
Differential Diagnoses & Workup: Transient Global Amnesia
Treatment & Medication: Transient Global Amnesia
Follow-up: Transient Global Amnesia
References
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References

  1. Eustache F, Desgranges B, Petit-Taboué MC, et al. Transient global amnesia: implicit/explicit memory dissociation and PET assessment of brain perfusion and oxygen metabolism in the acute stage. J Neurol Neurosurg Psychiatry. Sep 1997;63(3):357-67. [Medline].

  2. Strupp M, Bruning R, Wu RH, et al. Diffusion-weighted MRI in transient global amnesia: elevated signal intensity in the left mesial temporal lobe in 7 of 10 patients. Ann Neurol. Feb 1998;43(2):164-70. [Medline].

  3. Winbeck K, Etgen T, von Einsiedel HG, et al. DWI in transient global amnesia and TIA: proposal for an ischaemic origin of TGA. J Neurol Neurosurg Psychiatry. Mar 2005;76(3):438-41. [Medline].

  4. Nakada T, Kwee IL, Fujii Y, Knight RT. High-field, T2 reversed MRI of the hippocampus in transient global amnesia. Neurology. Apr 12 2005;64(7):1170-4. [Medline].

  5. Yamane Y, Ishii K, Shimizu K, Sofue K, Yoshikawa T, Miyamoto N, et al. Global cerebral hypoperfusion in a patient with transient global amnesia. J Comput Assist Tomogr. May-Jun 2008;32(3):415-7. [Medline].

  6. Bartsch T, Alfke K, Wolff S, Rohr A, Jansen O, Deuschl G. Focal MR spectroscopy of hippocampal CA-1 lesions in transient global amnesia. Neurology. Mar 25 2008;70(13):1030-5. [Medline].

  7. Miller JW, Petersen RC, Metter EJ, et al. Transient global amnesia: clinical characteristics and prognosis. Neurology. May 1987;37(5):733-7. [Medline].

  8. Matias-Guiu J, Blanquer J, Falip R, et al. Incidence of transient global amnesia in a Alcoi (Spain). Acta Neurol Scand. Aug 1992;86(2):221. [Medline].

  9. Lauria G, Gentile M, Fassetta G, et al. Incidence of transient global amnesia in the Belluno province, Italy: 1985 through 1995. Results of a community-based study. Acta Neurol Scand. May 1997;95(5):303-10. [Medline].

  10. Shuping JR, Rollinson RD, Toole JF. Transient global amnesia. Ann Neurol. Mar 1980;7(3):281-85. [Medline].

  11. Saura D, Peñafiel P, Morales A, Albert L, Martínez F, de la Morena G. Transient global amnesia after dobutamine--atropine stress echocardiography. Eur J Echocardiogr. Jul 2008;9(4):567-8. [Medline].

  12. Pantoni L, Bertini E, Lamassa M, et al. Clinical features, risk factors, and prognosis in transient global amnesia: a follow-up study. Eur J Neurol. May 2005;12(5):350-6. [Medline].

  13. Lewis SL. Aetiology of transient global amnesia. Lancet. Aug 1 1998;352(9125):397-9. [Medline].

  14. Schreiber SJ, Doepp F, Klingebiel R, Valdueza JM. Internal jugular vein valve incompetence and intracranial venous anatomy in transient global amnesia. J Neurol Neurosurg Psychiatry. Apr 2005;76(4):509-13. [Medline].

  15. Adams RD, Victor M, Ropper AH. Transient global amnesia. In: Principles of Neurology. 1997. New York: McGraw-Hill; 429-30.

  16. Ay H, Furie KL, Yamada K, Koroshetz WJ. Diffusion-weighted MRI characterizes the ischemic lesion in transient global amnesia. Neurology. Sep 1998;51(3):901-3. [Medline].

  17. Chung CP, Hsu HY, Chao AC, et al. Detection of intracranial venous reflux in patients of transient global amnesia. Neurology. Jun 27 2006;66(12):1873-7. [Medline].

  18. Grande LA, Loeser JD, Samii A. Recurrent transient global amnesia with intrathecal baclofen. Anesth Analg. Apr 2008;106(4):1284-7, table of contents. [Medline].

  19. Hinge HH, Jensen TS, Kjaer M, et al. The prognosis of transient global amnesia. Results of a multicenter study. Arch Neurol. Jul 1986;43(7):673-6. [Medline].

  20. Lauria G, Gentile M, Fassetta G, et al. Transient global amnesia and transient ischemic attack: a community- based case-control study. Acta Neurol Scand. Jun 1998;97(6):381-5. [Medline].

  21. Otrock ZK, Beydoun A, Barada WM, Masroujeh R, Hourani R, Bazarbachi A. Transient global amnesia associated with the infusion of DMSO-cryopreserved autologous peripheral blood stem cells. Haematologica. Mar 2008;93(3):e36-7. [Medline].

  22. Quinette P, Guillery-Girard B, Dayan J, et al. What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases. Brain. 2006;129:1640-58. [Medline].

  23. Schmidtke K, Ehmsen L. Transient global amnesia and migraine. A case control study. Eur Neurol. Jul 1998;40(1):9-14. [Medline].

  24. Spigno F, De Lucchi M, Migliazzi L, Cocito L. Transient global amnesia after breathing hyperoxic mixtures in otherwise regular dives. Clin Neurol Neurosurg. Mar 2008;110(3):259-61. [Medline].

  25. Vyhnálek M, Bojar M, Jerabek J, Hort J. Long lasting recurrent familiar transient global amnesia after betablocker treatment withdrawal: case report. Neuro Endocrinol Lett. Feb 2008;29(1):44-6. [Medline].

  26. Zweifler RM. Management of acute stroke. South Med J. Apr 2003;96(4):380-5. [Medline].

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Further Reading

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Keywords

amnesia, global amnesia, transient memory loss, paroxysmal loss of memory, transient loss of memory, immediate recall ability, remote memory, retrograde memory loss, semantic memory, syntax memory, visual-spatial skills, TGA, vertebrobasilar system, migraine variant, temporal lobe seizure, transient ischemic attack, emotional stress, cold-water exposure

Valsalva maneuver, venous anatomy anomalies, jugular vein valves, ischemia to memory areas in brain, back-pressure in jugular venous system, disruption of intracranial arterial flow, increased sympathetic activity, increased intrathoracic pressure, disrupted blood flow to thalamic structures, disrupted blood flow to mesial temporal structures, increased venous return to superior vena cava

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Contributor Information and Disclosures

Author

Roy Sucholeiki, MD, Director, Comprehensive Seizure and Epilepsy Program, The Neurosciences Institute at Central DuPage Hospital
Roy Sucholeiki, MD is a member of the following medical societies: American Academy of Neurology, American Epilepsy Society, and American Neuropsychiatric Association
Disclosure: UCB Pharma Honoraria Speaking and teaching

Medical Editor

Carmel Armon, MD, MSc, MHS, Professor of Neurology, Tufts University School of Medicine, Chief, Division of Neurology, Baystate Medical Center, Springfield, Massachusetts
Carmel Armon, MD, MSc, MHS is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Association of Neuromuscular and Electrodiagnostic Medicine, American Clinical Neurophysiology Society, American College of Physicians, American Epilepsy Society, American Medical Association, American Neurological Association, American Stroke Association, Massachusetts Medical Society, Movement Disorders Society, and Sigma Xi
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Howard S Kirshner, MD, Professor of Neurology, Psychiatry and Hearing and Speech Sciences, Vice Chairman, Department of Neurology, Vanderbilt University School of Medicine; Director, Vanderbilt Stroke Center; Program Director, Stroke Service, Vanderbilt Stallworth Rehabilitation Hospital; Consulting Staff, Department of Neurology, Nashville Veterans Affairs Medical Center
Howard S Kirshner, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Heart Association, American Medical Association, American Neurological Association, American Society of Neurorehabilitation, National Stroke Association, Phi Beta Kappa, and Tennessee Medical Association
Disclosure: Boehringer Ingelheim Honoraria Speaking and teaching; BMS/Sanofi Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching; Novartis Consulting fee Review panel membership

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Helmi L Lutsep, MD, Professor, Department of Neurology, Oregon Health and Science University; Associate Director, Oregon Stroke Center
Helmi L Lutsep, MD is a member of the following medical societies: American Academy of Neurology and American Stroke Association
Disclosure: Co-Axia Consulting fee Review panel membership; Talecris Consulting fee Review panel membership; AGA Medical Consulting fee Review panel membership; Boehringer Ingelheim Honoraria Speaking and teaching; Boston Scientific Honoraria Speaking and teaching; Concentric Medical None Review panel membership; Northstar Neuroscience  Review panel membership; ev3 Consulting fee Review panel membership

 
 
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