Complete amnesia

Introduction Transient global amnesia syndrome (TGA) is a sudden clinical syndrome of transient near-forgetting. It lasts for 1 to 24 hours. During the attack, patients cannot remember new things, with varying degrees of distance. Memory loss, but self-awareness, speaking, writing, and computing power remain good. The clinical features of TGA are generally occurring in the elderly with moderate health or no obvious cardiovascular and cerebrovascular diseases. It is characterized by sudden loss of memory, short-term access to new knowledge, varying degrees of retrograde forgetting, often fidgeting, and repeatedly asking the same questions. Interictal conversation, writing and computing skills remain normal, personality retention, complete self-knowledge, symptoms lasting for several hours, complete recovery within 24 hours (more than 3-6 hours). More women than men. The prominent clinical symptoms of the patient were sudden transient near-memory loss accompanied by dizziness and head swelling, complete self-knowledge, unconscious loss and positive signs of nervous system, and complete recovery within 24 hours, in line with the diagnostic criteria of TGA.

Cause

Reasons for complete amnesia:

TGA belongs to the original anthrax or the cause is unknown. According to the literature, the disease has been seen in the following cases: migraine, sprinkling and digitalis poisoning, bradycardia, atrial fibrillation, coronary sputum and angiography, aorta Valvular disease, mitral valve prolapse, cardiac surgery, hypertensive arteriosclerosis, hyperlipidemia, diabetes, polycythemia vera, vascular disease, tumor, craniocerebral trauma and epilepsy.

Most currently think:

1. TGA is essentially a special type of TIA. Most scholars believe that the lack of blood supply to the posterior cerebral artery or the vertebral-basal artery affects the hippocampus and hippocampus in the posterior part of the leaves. These structures are related to memory. It is believed that the marginal system of the sacral sacral papillary body plays an important role in memory formation. The thalamus and hippocampus are the main components of the PaPez memory loop. This structure is mainly related to the internal temporal lobe through the hippocampus and the inferior thalamic pathway. If the two pathways are combined, the severe memory impairment occurs.

2. TGA is related to migraine headache. It has been found that 25% to 30% of adult patients have typical or common migraine headaches, as well as emotional and psychological stress such as anger and grief, which promotes the release of catecholamines, increases vascular tone, and induces angiogenesis. Therefore, vasospasm is also considered to be TGA. Another important cause. At the onset of TGA, TCD showed abnormal blood flow in the common carotid artery, SPECT showed that the bilateral temporal lobe was hypoperfused, PET showed cerebral oxygen metabolism and decreased tissue oxygen consumption, which were similar to those of migraine.

3. Whether TGA is epilepsy. Because of the sudden, transient, stereotypical, and reversible nature of TGA, a small number of patients with EEG as a double temporal lobe have been considered epilepsy. However, TGA lasts for a long time, unconsciousness and most EETs are normal. TGA is a benign course and can be treated symptomatically according to the condition. This patient has risk factors for cerebrovascular disease, such as hypertensive history for many years, hyperlipidemia, considering the pathogenesis may be TIA, mainly to treat primary disease.

an examination

Related inspection

Brain Doppler Ultrasound (TCD) Brain MRI

Diagnosis of complete amnesia:

1 can indeed prove the presence of memory disorders.

2 There is a clear antegrade amnesia during the onset of illness.

3 Unconscious turbidity, personality defects, aphasia and misuse.

4 There were no symptoms of focal neurological damage during the attack.

5 does not have the characteristics of seizures.

6 Paroxysmal forgetting must be restored within 24 hours.

7 should be excluded from the recent history of head trauma and active epilepsy, such as the use of anti-epileptic drugs or the author of an epilepsy in the past 2 years.

8 Most patients had normal EEG, head CT and TCD.

Differential diagnosis

Complete amnesia needs to be identified with the following diseases:

(1) epileptic amnesia: repeated frequent episodes, short duration. Often accompanied by automatic disease and personality disintegration. It can be seen that there is epileptic discharge. Jaffe et al. used intravenous injection to identify the symptoms of epileptic seizures, while the memory and orientation disorders of TGA patients were aggravated.

(2) Psychogenic oblivion: It is good for patients with rickets. They often have mental shaving, depression, anxiety and other factors before the onset, persistent memory decline and self-knowledge defects, and can regain new information.

(3) migraine: may be associated with amnesia, especially in the basilar artery type, the relationship between stiffness and TGA remains to be further studied} (4) Korsakoff psychosis; mostly caused by lack of vitamin B1 after alcoholism, memory impairment Persistent.

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