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Transient global amnesia is anterograde and retrograde amnesia usually that suddenly usually begins and lasts up to 24 hours. The diagnosis is primarily clinical, but also includes laboratory tests and / or CT and MRI to check the central circulatory situation. This amnesia typically forms spontaneously, but it can recur. There is no specific treatment, but the underlying diseases should be treated.
Most (75%) cases of transient global amnesia occur in people aged 50 to 70; this disorder rarely occurs in patients <40th
Transient global amnesia is anterograde and retrograde amnesia usually that suddenly usually begins and lasts up to 24 hours. The diagnosis is primarily clinical, but also includes laboratory tests and / or CT and MRI to check the central circulatory situation. This amnesia typically forms spontaneously, but it can recur. There is no specific treatment, but the underlying diseases should be treated. Most (75%) cases of transient global amnesia occur in people aged 50 to 70; this disorder rarely occurs in patients <40th Etiology The etiology of transient global amnesia is not clear. Proposed mechanisms include those with whom migraine, hypoxia and / or ischemia, venous flow abnormalities, or seizures are treated as well as psychological factors. Recent data suggest that the vulnerability of CA1 neurons is associated with metabolic stress of central importance; the resulting damage triggers a cascade of changes that lead to an impairment of hippocampal function. Producing a distinct thereof benign form of transient global amnesia may occur after prolonged alcohol consumption, medium-sedating doses of barbiturates, the use of various illicit drugs or sometimes even after relatively small Benzodiazepindosen (v. A. Midazolam and triazolam). Among the events that can trigger a transient global amnesia, include Sudden immersion in cold or hot water Physical exertion Emotional or psychological stress pain medical procedures make intercourse a Valsalva maneuver symptoms and discomfort patients often after a triggering event before. The classic presentation at transient global amnesia is the sudden onset of severe anterograde amnesia But a less severe retrograde amnesia can be the symptom. Episodes usually last 1-8 hours, but also (rarely) from 30 min to 24 h. However, patients are often disoriented to time and place, not usually for personal identity. Many patients are anxious or restless and may repeatedly ask questions about just happening events. The voice function, attention, visual-spatial and social skills are preserved. When the episode ends, the amnesia is gradually reduced. The benign temporary amnesia after substance intake is different because it is selective retrograde (ie for events during and before intoxication) Refers specifically to drug-associated events not cause confusion (when the acute intoxication is even overcome) return only when similar amounts be taken of the same drug diagnosis primary clinical evaluation brain imaging diagnosis of transient global amnesia is made primarily clinically. Neurological examination typically reveals no other abnormalities except the faulty memory. be excluded ischemia of the brain must (Ischemic stroke: diagnosis). Laboratory tests should include complete blood count, coagulation status and evaluation with regard to a hypercoagulable state. Brain CT, MRI of the brain, or both, are carried out normally. A high-resolution diffusion-weighted MRI should be performed to exclude cerebral ischemia, if it is suspected. An MRI can show focal hyperintense lesions that correlate with reduced diffusion in the lateral hippocampus. During the first 24 h after onset of symptoms detected in an MRI lesions in the hippocampus with only 12% of patients. The detection is increased by 81%, when an MRI is carried out 3 days later and thinner 3-mm sections and higher b-values ??are used. Why the lesions are more visible after 3 days, is not known. The EEG usually shows non-specific problems and is unnecessary unless a seizure etiology is suspected or the episodes occur again. Prognosis The prognosis is good. The symptoms typically last <24 h at. If the interference subsides, amnesia decreases but can remain a memory lapse for the events during the episode. Mostly, the episodes are not repeated, unless it is in the cause of a seizure disorder or migraine. The repetition rate based on the total lifetime is between 5 and 25%. The risk of stroke is not increased. Therapy treatment of the cause, if possible, a specific treatment is not indicated in transient global amnesia. However, the underlying condition should be treated. Important points transient global amnesia usually affects patients aged 50 to 70. A high-resolution diffusion MRI of the brain should be performed to rule out ischemia as a cause. Although memories that have been lost can not be recovered, the memory function tends to be restored within 24 hours, and episodes do not occur again usually on.