Case Of Transient Global Amnesia Research Articles

Retrospective analysis of cases of transient global amnesia admitted to the hospital

Introduction. Transient global amnesia (TGA) is a clinical syndrome, the main clinical manifestation of which is sudden development of anterograde and retrograde amnesia, lasting not more than 24 hours, without other general cerebral or focal neurological symptoms.The aim of the work was to reveal the peculiarities of clinical manifestations and data of additional methods of examination of patients with TGA syndrome referred to the primary vascular department with suspected acute cerebral circulation disorder (ACCD).Materials and methods. The study included 16 patients with transient global amnesia diagnosed according to the diagnostic criteria of Hodges and Warlow (1990). All patients underwent a detailed neurological and general medical examination. Electrocardiography, multispiral computer tomography of the head, echocardiography, ultrasound duplex scanning of the main arteries of the head and neck, laboratory examination (lipid spectrum) were performed. The Brief Mental Status Rating Scale was used to assess cognitive impairment.Results. The majority of patients had elevated blood pressure (BP). The leading trigger factor of transient global amnesia was stress. The duration of amnesia ranged from 1.5 to 5 hours. There was a significant impairment of short-term memory. On the first and second days of hospitalization, 50% of patients had normal cognitive functions on a brief mental status assessment scale, but by the 5th−7th day only 12.5 % of patients had abnormalities. Ultrasound markers of atherosclerosis in the form of intima-media complex thickening and dyslipidemia were found in 6 patients. Signs of left ventricular hypertrophy were found in the majority of patients. Discussion TGA is a relatively rare condition and an understudied syndrome. Due to its suddenness of clinical manifestation, TGA requires differential diagnostics with acute cerebral circulatory disorders, epilepsy, acute hypertensive encephalopathy and psychogenic amnesia.Conclusion. The clinical features of TGA identified in the patients were a history of arterial hypertension, elevated BP during an episode of TGA. The leading provoking factor was stress. TGA episode occurred predominantly in the first half of the day. The majority of patients had complaints of headache on admission. Cognitive disorders detected in patients on the first and second days of the disease quickly regressed to normal. Left ventricular hypertrophy was detected in most patients.

A Case of “Spotty” Transient Global Amnesia

A case of transient global amnesia occurring after sexual intercourse is presented with a somewhat unusual symptomatology. Instead of an all-encompassing amnesia, as has usually been reported in the literature, the patient’s amnesia was evident in spots. Therefore, transient global amnesia after sexual relations may go unnoticed in patients if the amnesia is temporary, as is usually the case, and is restricted to a few memories.

A Case of Transient Global Amnesia Triggered by Sexual Intercourse

Transient global amnesia (TGA) is described as a sudden onset of anterograde and retrograde amnesia. In this case report, we present a case of a 52-year-old man who came to our hospital experiencing sudden-onset confusion and memory loss an hour after engaging in sexual activity with his wife. Before this, the patient had no previous medical history. Four hours following the event, a non-contrast computed tomography (CT) scan was performed and showed no signs of any intracranial pathology. In addition, T1-weighted and T2-weightedmagnetic resonance imaging (MRI) was performed13 hours following the incident and demonstrated punctate focus of restricted diffusion in the medial right temporal lobe in the region of the hippocampus. A diagnosis of transient global amnesia was made after other causes were ruled out. We present this rare case of transient global amnesia (TGA), highlighting sexual intercourse as a probable triggering component of the disease and demonstrating how crucial it is to rule out other severely morbid conditions before managing TGA.

COVID-19 Vaccine-Associated Transient Global Amnesia: A Disproportionality Analysis of the WHO Safety Database.

Coronavirus disease 2019 (COVID-19) spread rapidly, resulting in a global pandemic for which vaccines were quickly developed. As their safety continues to be monitored, cases of transient global amnesia (TGA) following mRNA vaccination with elasomeran have been reported. TGA is characterized by sudden onset of anterograde amnesia with preservation of other cognitive functions and resolution within 24 h. We aimed to investigate the potential link of TGA with COVID-19 vaccines. We queried the World Health Organization VigiBase® for all reports of “Transient global amnesia”, up to 6 December 2021. Disproportionality analysis relied on the Reporting Odds Ratio (ROR) with its 95% Confidence Interval (CI) and the Information Component (IC). A positive lower end of the 95% CI of the IC (IC025) is used to statistically detect a signal. Of all TGA cases, 289 were associated with a COVID-19 vaccine, representing the most frequent association. Tozinameran was mostly represented (147, 50.8%), followed by AZD1222 (69, 23,8%), elasomeran (60, 20.8%), and JNJ-78436735 (12, 4.2%). With an IC025 > 0, COVID-19 vaccines showed a significant ROR (5.1; 95%CI 4.4–6.0). Tozinameran reached the strongest ROR (4.6; 95%CI 3.9–5.0), followed by elasomeran (4.4; 95%CI 3.4–6.0), AZD1222 (3.8; 95%CI 3.0–5.0), and JNJ-78436735 (3.7; 95%CI 2.1–6.0). Our analysis of COVID-19 vaccines-related TGA reports shows significant disproportionality. Cerebrovascular, inflammatory, or migrainous mechanisms may underlie this association. Yet, numerous confounding factors cannot be tackled with this approach, and causality cannot be ascertained. The identification of this trigger of TGA may help the clinician in his etiological research.

Emotional stress-induced transient global amnesia with bilateral hippocampal ischemic lesion

The paper describes a clinical case of transient global amnesia (TGA) in a male patient who has experienced prolonged stress at work and at home. The middle-aged man was admitted to hospital disoriented, constantly repeating the same questions. The patient did not remember what had happened that morning before his admission to the hospital. Brain magnetic resonance imaging revealed bilateral punctate hippocampal DWI hyperintensity. The patient has not been observed to have risk factors for cerebrovascular events. Neuropsychological examination has shown that the patient does not have adequate strategies to cope with the sequels of long-term intense stress accompanied with emotion suppression. The described case confirms that psychological instability may be one of the precipitating factors for TGA.

MON-LB056 A Case of Transient Global Amnesia and Pituitary Tumor

Introduction Transient Global Amnesia (TGA) is benign clinical syndrome of reversible anterograde amnesia that occurs in middle-aged and older individuals. Only few cases on literature have reported co-occurrence of TGA and pituitary lesion. Case Presentation 72 year old man with history of hypertension, hyperlipidemia, coronary artery disease presented with a transient amnestic state where he appeared confused unable to recall the time, asking multiple times and forgetting things they had discussed repeatedly. The anterograde amnestic episode lasted approximately 5 hours and there was no motor weakness, aphasia, conscious disturbance or any other focal neurological deficit. Patient returned fully to his baseline. Prior to this event he was in good health, no excess headache, no vision issues, no increase in size of hands or feet, and no history of head trauma. CT head noted note a mass in the left sella extending into the cavernous sinus. CT perfusion of head and neck demonstrated no significant stenosis. MRI brain characterized a hypointense T1-weighted sequence with homogeneous contrast enhancement eroding the dorsum sella measuring 1.5 x 1.4 x 1.4 cm. The pituitary gland is not well separated from this mass and the basilar and internal carotid arteries were patent. Labs show prolactin to be >1000,testosterone and LH was low but FSH, Free T4, TSH, ACTH, am cortisol, IGF-1 were normal range. Labs showed normal electrolytes and normal glucose level. Discussion TGA is an isolated, sudden and self-limited disturbance of anterograde amnesia lasting less than 24horus and unaccompanied by other focal neurological deficits or seizure. The etiology of TGA is not completely clear with hypotheses including migrainous or epileptic phenomenon, vascular with transient interruption of vascular perfusion of memory related structure versus psychogenic disorder theory. In our case the CT and MR imaging studies disclosed a case of pituitary mass. The markedly high serum prolactin level and imaging finding are suggestive of prolactin-producing adenoma, although histological confirmation was not obtained. Literature review has showed a case of TGA presenting with hemorrhagic pituitary adenoma or pituitary apoplexy, postulating that the compression from bleeding adenoma affecting the memory eloquent pathways of hyppocampus.On our index case there is no exact anatomical relationship with memory related structure. It is not clear if TGA and pituitary adenoma finding on our patient is due to a chance of concurrence or it has etiological association. Although TGA is considered as a benign and functional disorder, neuroimaging need to be obtained to exclude organic causes of amnesic events. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.

The underlying causes of transient global amnesia are variousthe cerebral infarction is common some cases of TGA show negative finding of initial brain diffusion imaging

Background: The underlying causes of transient global amnesia are very various. Among them, the cerebral infartion is most common. Some cases of transient global amnesia show negative findings of initial brain diffusion weighted MRI imaging. We report two cases of transient global amnesia with initial negative brain diffusion imaging & follow up positive brain diffusion imaging.

Serious Adverse Reactions Caused by Counterfeit Drugs. A Clinical Case of Transient Global Amnesia Caused by Dietary Supplement Containing a High Dose of Sildenafil

On 25/11/2014 the patient VHG arrives at emergency department of Cardarelli Hospital in Naples following prolonged confusional state and total loss of memory in the last 24 hours. The episode is diagnosed as transient global amnesia (TSA). During the hospitalization the patient receives specialist visits that don't reveal any abnormalities. The patient reports that he assumed, a few hours before the onset of amnesia, a dietary supplement. The product named Sex Bull, purchased online, it’s indicated for the improvement of sexual performance both in men than in women and, in according to label, it doesn't contain any pharmacological active ingredient. Poison Control Centre of Cardarelli Hospital provides to send a sample of tablets of Sex Bull to Superior Institute of Health (Rome) for a qualitative and quantitative determination of components. The analyses show the presence of Paracetamol, vitamin C, sugar and at the dosage of 100 ± 1.5 mg is a drug used in clinical practice for the treatment of erectile dysfunction and the sale of pharmaceutical products containing the active substance Sildenafil is subject to medical prescription. In literature, are published several case-reports and a review reporting cases of TGA following a first administration of Sildenafil. In this case report, it’s difficult to establish the causal link between the adverse drug reaction (ADR) and the consumption of the active substance Sildenafil, because Sex Bull” it is a counterfeit drug. The production and distribution of counterfeit drugs is not done according to Good Manufacturing Practice and Good Distribution Practice so the quality of pharmacological active ingredients isn't guaranteed. Because of these reasons it is not possible establishing any form of interaction between counterfeit products and other pharmaceutical therapies in progress or the ability of these drugs to induce serious ADR or aggravate a pre-existing medical condition.

Cardiac troponin T elevation associated with transient global amnesia: another differential diagnosis of ‘troponosis’

Elevated cardiac troponin (cTn) levels can be detected in a variety of diseases with or without signs of myocardial ischaemia. Acute neurological disorders such as subarachnoid haemorrhage, stroke, transient ischaemic attack, epileptic seizures, and traumatic head injury can cause cTn elevation with and without myocardial wall motion abnormalities. We report a case of transient global amnesia with elevation and dynamic rise of highly sensitive troponin T (hsTnT) without clinical symptoms or signs of ischaemia. Cardiac work up was otherwise normal, with no signs of atherosclerotic coronary artery disease on coronary angiogram. Myocardial systolic function was also normal. In the era of highly sensitive cTn assays, dynamic elevations of cTn are seen in a number of acute conditions unrelated to myocardial ischaemia. Transient global amnesia should be added to the list of acute neurological disorders where cTn release can be present, even in the absence of stress-induced cardiomyopathy.

Transient global amnesia caused by hippocampal infarct: case report and review of literature

BackgroundTransient global amnesia is a fairly common occurrence in patients arriving to the emergency department. In most cases, transient global amnesia is benign, and the etiology remains unknown; however, it is important to exclude the rare but serious causes ensuring proper treatment and prevention of serious complication. Case reportWe present a rare case in which a patient arrived with amnesia, and after full evaluation; a subtle ischemic region in the hippocampus was identified, allowing the patient to be treated. In most cases of transient global amnesia, the cause is seldom identified. ConclusionsWe review the diagnostic criteria, risk factors, and imaging considerations associated.

Two Cases of Delayed-onset Transient Global Amnesia After Saline-contrast Transthoracic Echocardiography

We present 2 cases of transient global amnesia (TGA) with delays of 1 and 2 hours after saline-contrast transthoracic echocardiography. The unique presentation in these cases may help elucidate the possible mechanisms underlying TGA. (1) A 63-year-old woman admitted for lower extremity arterial thrombosis with TGA onset 1 hour after saline-contrast echocardiography. (2) A 75-year-old woman admitted to rule out myocardial infarction with TGA onset 2 hours after saline-contrast echocardiography. The precipitating events of TGA are varied and an understanding of the mechanism(s) underlying the phenomenon is incomplete. However, the presence of a delay after the trigger event as described in these cases is unique and informative in that it lends strength to some proposed mechanisms over others in this subset of TGA presentations.

A Case of Transient Global Amnesia due to Marijuana Use

A Case of Transient Global Amnesia due to Marijuana Use

Impairment of recognition memory and hippocampal long-term potentiation after acute exposure to clioquinol

Clioquinol (CQ) was associated with cases of transient global amnesia and with the neurodegenerative syndrome subacute myelo-optico-neuropathy (SMON) in humans. However, CQ forms lipophilic chelates with cations and has the potential as a scientific and clinical tool used for selective modulation of histochemically reactive zinc pools. The relationship among transient lack of synaptic zinc release, hippocampal long-term potentiation (LTP) induction and cognitive memory is poorly understood. To evaluate the role of synaptic zinc release, in the present study, hippocampal LTP induction and cognitive behavior were examined in young rats after i.p. injection of CQ (30 mg/kg). Intracellular zinc detected by Timm's stain and extracellular (synaptic cleft) zinc detected by ZnAF-2 were significantly decreased in the hippocampus 6 h after CQ injection. The molecular layer of the dentate gyrus, in which perforant path-granule cell synapses exist, was most responsive to CQ injection. Dentate gyrus LTP was induced similarly to the control 2 h after CQ injection, while significantly attenuated 6–24 h after CQ injection. In the training trial of the object recognition memory 2 h after CQ injection, there was no significant difference in learning behavior between the control and CQ-treated rats. In the test trial, CQ-treated rats showed normal recognition memory 1 h after the training, whereas recognition memory deficit 24 h after the training unlike the control rats. These results indicate that acute exposure to CQ impairs long-term (24 h) memory in the hippocampus of young rats. The CQ-mediated attenuation of dentate gyrus LTP, which may be associated with the transient lack of zinc release from zincergic neurons, seems to be involved in the impairment of the long-term memory.

A Case of Transient Global Amnesia due to Marijuana Use

Transient amnesia is a temporary version of the amnestic syndrome. The most striking example of transient amnesia is the transient global amnesia (TGA) syndrome which lasts from several to 24 hours, with or without retrograde components of impairment, and any signs of neurological deficit in nature. In this syndrome, an otherwise cognitively intact individual suddenly loses memory of recent events, asks repetitive questions about his/her environment, and sometimes confabulates (1). TGA is typically described as amnesia of sudden onset regarding events of the present and the recent past (2). It can be caused by central vascular or ischemic lesions. Diagnosis is primarily clinical but includes laboratory tests and radiologic evaluation. TGA typically remits spontaneously, but may recur. There is no specific treatment for amnesia. General stabilization of the patient is indicated (2). Many patients are anxious or agitated and may repeatedly ask questions concerning transpiring events. In the neurologic examination only disturbed memory can be found (3). Upon mental status examination, language function is preserved, which indicates a preservation of semantic and syntax memory. Attention is spared, visual-spatial skills are intact, and social skills are retained. Symptoms typically last less than 24 hours. As the syndrome resolves, the amnesia improves, but the patient may be left with a distinct lapse of recollection for events during the attack. The patient’s behavior is normal except for incessant, repetitive questioning about his/her immediate circumstances (e.g., “What am I doing here?”; “How did we get here?”) (4). Cannabis is one of the most frequently used substances. Cannabis and its constituent cannabinoids are known to impair several aspects of cognitive function, with the most potent effects on shortterm episodic and working memory in humans (5). Marijuana is used by inhalation in cigars or taken orally. When it is taken by the oral route its effects are seen in a delayed manner, so the inhalation type is used mostly to achieve the desired psychoactive effects (6). After al the cigar was burnt, the peak effects are seen in 20 minutes and disappear in 3 hours. A cigar of marijuana contains 5-20 mg THC (tetrahydrocannabinol). Approximately 50% of the THC pass to the alveolar spaces. The most encountered psychotropic side effects of THC are; lethargy, sedation, euphoria, psychological relaxation, euphoria and sometimes, inhibition of the psychological inhibitions as alcohol does, disturbance in the perception of time and location (like feeling of delays in time and elongation of the distances), disturbance in the Abstract Transient global amnesia (TGA) has been a well-described phenomenon for more than 40 years. It presents with a paroxysmal, transient loss of memory. Immediate recall ability and remote memory are preserved. However, patiens experience striking loss of memory for recent events and an impaired ability to retain new information. In some cases, the degree of retrograde memory loss is mild. Marijuana induced transient global amnesia is a rare side effect. Here, we present a case of memory loss for a short period of time after use of marijuana. (JAEM 2012; 11: 190-2)

Neuropsychological testing during a transient global amnesia episode and its follow-up.

A case of transient global amnesia has been neuropsychologically assessed during the attack. Global involvement of any memory modalities and far-reaching retrograde amnesia were found. Follow-up retesting, 1 week and 6 months later, showed persistence of mild verbal memory impairment.

The hippocampal region of rats and mice after a single i.p. dose of clioquinol: Loss of synaptic zinc, cell death and c-Fos induction

Clioquinol (CQ) is able to chelate synaptic zinc, which can modulate excitatory and inhibitory neurotransmission. In humans, CQ was associated with cases of transient global amnesia (TGA) and with the neurodegenerative syndrome subacute myelo-optico-neuropathy (SMON). We examined the CQ induced loss of synaptic zinc, cell death and c-Fos induction in rats and mice. In rats, we found a strong reduction of histochemically reactive synaptic zinc no later than 4 h after the injection of the lowest dose of CQ (50 mg/kg) and, for all doses used, a return to control levels after 48 h. There was no evidence of cell death for any dose and up to 1 week after CQ injections. Only a slight induction of c-Fos was seen in the hippocampus for the higher doses used (100–200 mg/kg). In mice injected with 100 mg/kg, CQ also resulted in a fast loss of synaptic zinc. c-Fos was induced after 4 h in cell populations of the hippocampal region and other parts of the telencephalon, and substantially increased after 24 h. One day after the injection we found a pattern of cell loss (hilus, parts of CA3, CA1 and layer III of the medial entorhinal cortex) reminiscent of that seen in models of temporal lobe epilepsy. In conjunction with published data on the behavioral effects of zinc chelation and the modulatory effects of zinc in excitatory neurotransmission, our results indicate that the loss of synaptic zinc may have been involved in TGA and the neuropathology associated with SMON.

P.1.e.002 A case of transient global amnesia with high signal intensities at the both hippocampi on diffusion-weighted MRI

Magnetic resonance imaging (MRI) serves as the principal imaging modality to diagnose and plan treatment for children with cutaneous vascular anomalies. While routine MRI protocols can lead to the correct diagnosis in the majority of cases, the imaging appearances can sometimes be nonspecific or confusing, yielding more than one possible diagnosis. This review highlights specific MRI sequence recommendations and scanning tips that can optimize the imaging protocol to increase diagnostic confidence.

Transient global amnesia after dobutamine–atropine stress echocardiography

Dobutamine-atropine stress echocardiography is a useful and relatively safe test for coronary artery disease assessment. However, possible complications should be recognized. We describe a case of transient global amnesia in a woman who underwent a standard-protocol dobutamine-atropine stress echocardiogram for coronary ischaemia detection, after having complained about chest pain. The test was not positive for coronary ischaemia, but a typical picture of transient global amnesia ensued. Symptoms shortly resolved spontaneously. Neurological work up was negative for organic disease. Transient global amnesia is a neurological syndrome of unknown origin and good prognosis. Dobutamine-atropine stress echocardiography can be added to the described precipitants of transient global amnesia. This neurological syndrome should be taken into account as a possible complication of dobutamine-atropine stress echocardiography.

Transient global amnesia in the district general hospital

Cases of transient global amnesia (TGA) seen by one consultant neurologist over a 4-year period (2002-2005 inclusive) were identified. Of 10 possible cases, eight fulfilled suggested diagnostic criteria. Five cases were seen as ward consultations, three in outpatient clinics; seven were seen in district general hospitals. Six of the eight cases had already been seen by hospital physicians, whose working diagnoses included stroke/TIA and epilepsy. In some cases, this had resulted in inappropriate investigation, treatment and advice. Although rare, TGA is a diagnosis both hospital physicians and general practitioners need to be aware of in order to avoid potential pitfalls. The critical importance of collateral history in reaching the diagnosis is emphasised.

Magnetic Resonance Imaging Changes in a Patient with Migraine Attack and Transient Global Amnesia After Cardiac Catheterization

The presence of magnetic resonance imaging (MRI) abnormalities in patients with transient global amnesia has been an interesting phenomenologic finding. Several theories surround the occurrence of this syndrome, but little is known about its true physiopathology. We present a case of transient global amnesia after cardiac catheterization associated with migraine headache and MRI changes compatible with an ischemic insult. A discussion on potential explanations for this finding is made, as well as a review of the pertinent literature.