What causes amnesia?

Updated: Sep 19, 2018
  • Author: Richard D Shin, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Answer

Transient global amnesia (TGA) is seen in previously well, usually middle-aged patients who present with a sudden onset of confusion, amnesia, and anxious perseveration. [11] TGA can occur spontaneously or following minor trauma, exertion, or emotional stress. The amnesia usually lasts a few hours, with full recovery and rare recurrence.

Various causes have been proposed for TGA: most recently, transient ischemia-like attacks or perhaps ministrokes in the hippocampal or thalamic memory areas of the brain. Although the incidence of cerebrovascular risk factors in TGA is low, those patients with such risk factors (eg, hypertension, smoking, diabetes mellitus, hypercholesterolemia) should be considered for antiplatelet therapy. Although TGA may involve a transient ischemia to brain areas involved with memory (hippocampus, thalamus, mediobasilar temporal lobe), symptoms typically resolve more slowly than TIA. In addition, future risk of stroke and death are lower than in TIA. All patients with TGA should be admitted for monitoring and further workup.

Traveler’s amnesia is typically seen following a nap on an airplane after taking a short-acting hypnotic, such as alprazolam, triazolam, or zolpidem.

Korsakoff syndrome is caused by neuronal damage that results from thiamine deficiency in association with chronic alcohol abuse. It is usually preceded by an episode of Wernicke encephalitis (eg, ataxia, confusion, oculomotor palsy), typically precipitated by administration of glucose to a malnourished alcoholic without concomitant parenteral thiamine. Confabulation is a hallmark finding of Korsakoff syndrome (also called Korsakoff psychosis).


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