Transient global amneisa natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hasnain Ali Moryani, MBBS.

Natural History of the Disease

  • Transient global amnesia is a sudden, reversible syndrome of memory disturbance characterized by complete anterograde amnesia and a variable period of retrograde amnesia.[1]
  • The episode usually lasts for several hours and gradually resolves as the patient regains the ability to form new memories.[1]
  • During recovery, the period of retrograde memory loss gradually shrinks from days or hours to minutes.[1]
  • The episode leaves a permanent gap in memory for the period of the attack and for several hours before its onset.[1]
  • In a retrospective series of 277 cases, episodes lasted a mean of 6 hours, with most lasting 2 to 12 hours.[2]
  • In most series, approximately 15% of patients have had more than one episode, with an average interval between episodes of about 2 years.[2]
  • Almost two thirds of patients with recurrent episodes had three or more definite or probable episodes.[2]
  • Estimates of recurrence frequency and intervals have varied among studies.[1]˒[2]˒[3]

Complications

  • After the episode, some patients have a mild headache.[1]
  • Nausea and dizziness have been reported infrequently.[1]
  • The neurologic examination is normal during and after the episode.[1]
  • A permanent memory gap remains for the epoch of the episode and for a period before onset.[1]
  • Extensive evaluation is generally not necessary unless there are atypical features suggesting another diagnosis such as transient ischemic attack, stroke, seizure, or postconcussive amnesia.[1]

Prognosis

  • The overall prognosis is good.[1]
  • Transient global amnesia is described as a benign, self-limited disorder.[1]
  • Approximately 15% of patients experience recurrences years later.[1]˒[2]
  • Analyses from several series indicate that the risk of subsequent ischemic stroke is not increased after transient global amnesia, although one propensity-matched study suggested a minimally higher risk.[4]˒[5]˒[6]
  • Despite many theories, the cause remains unknown.[1]

References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 BENDER MB (March 1960). "Single episode of confusion with amnesia". Bull N Y Acad Med. 36 (3): 197–207. PMC 1806291. PMID 13798787.
  2. 2.0 2.1 2.2 2.3 2.4 Miller JW, Petersen RC, Metter EJ, Millikan CH, Yanagihara T (May 1987). "Transient global amnesia: clinical characteristics and prognosis". Neurology. 37 (5): 733–7. doi:10.1212/wnl.37.5.733. PMID 3574671.
  3. Morris KA, Rabinstein AA, Young NP (December 2020). "Factors Associated With Risk of Recurrent Transient Global Amnesia". JAMA Neurol. 77 (12): 1551–1558. doi:10.1001/jamaneurol.2020.2943. PMC 7489420 Check |pmc= value (help). PMID 32865551 Check |pmid= value (help).
  4. Zorzon M, Antonutti L, Masè G, Biasutti E, Vitrani B, Cazzato G (September 1995). "Transient global amnesia and transient ischemic attack. Natural history, vascular risk factors, and associated conditions". Stroke. 26 (9): 1536–42. doi:10.1161/01.str.26.9.1536. PMID 7660394.
  5. Mangla A, Navi BB, Layton K, Kamel H (February 2014). "Transient global amnesia and the risk of ischemic stroke". Stroke. 45 (2): 389–93. doi:10.1161/STROKEAHA.113.003916. PMC 3946840. PMID 24309586.
  6. Lee SH, Kim KY, Lee JW, Park SJ, Jung JM (April 2022). "Risk of ischaemic stroke in patients with transient global amnesia: a propensity-matched cohort study". Stroke Vasc Neurol. 7 (2): 101–107. doi:10.1136/svn-2021-001006. PMC 9067272 Check |pmc= value (help). PMID 34702748 Check |pmid= value (help).