Memory loss resident survival guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo, M.D.

Overview

Amnesia is a condition in which memory is disturbed or lost. The causes of amnesia can be organic or functional. Organic causes include damage to the brain through trauma or disease or the use of certain (generally sedative) drugs. Functional causes are psychological factors, such as defense mechanisms. Hysterical post-traumatic amnesia is an example of this. Amnesia may also be spontaneous, in the case of transient global amnesia. This global type of amnesia is more common in middle-aged to elderly people, particularly males, and usually lasts less than 24 hours. Memory loss can be partial or total and is normally expected as we get older.

Causes

Life Threatening Causes

• Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.
• Most acute causes of amnesia are considered life-threatening, among them, are the following:
  • Electrolyte imbalances
  • Head trauma
  • Hypoglycemia
  • Infections
  • Intoxications

Common Causes

• • Alzheimer
  • Vascular dementia
  • Frontotemporal dementia
  • Vitamin deficiency
  • Depression

Diagnosis

• Shown below is an algorithm summarizing the diagnosis of amnesia according to the the American Academy of Neurology guidelines.

Patient with amnesia

Acute onset

Chronic onset

Measure vitamin B12, and folic acid, and TSH

Abnormal?

Yes

Vitamin deficiency, hypothyroidism

Fluctuating course, inattention, disorganized thinking, or altered level of consciousness?

Positive for SIGE CAPS questionary?

Yes

Depression

Yes

No

Delirium

Dementia

Take history and perform physical examination

Take history and perform physical examination

History of head trauma?

Yes

No

Concussion, post-concussive amnesia

Measure urine toxicology, CBC, creatinine, electrolites, and glucose to reveal cause

Initial short term memory loss

Vascular risk factors, imaging evidence of cerebrovascular involvement

Young age, behavioral symptoms or language impairment

Bradikinesia or features of parkinsonism, fluctuating cognition, visual hallucinations

Dementia occuring 1 year after onset of Parkinson disease

Alzheimer disease

Vascular dementia

Frontotemporal dementia

Dementia with Lewy bodies

Parkinson disease dementia

Do's

• The content in this section is in bullet points.

Don'ts

• The content in this section is in bullet points.