TEACHING PEARLS After an extensive negative workup, transient global amnesia should be considered in a patient with self-resolving anterograde amnesia.
This condition typically affects middle- aged adults and is often seen in females more often than males. It can be associated with migraines but it is often thought to be related to a variety of triggers such as stress, environmental factors, and even some physical maneuvers, like Valsalva.
Patients often experience “broken record phenomenon” in which they frequently repeat the same phrase due to short term memory lapses. It is also reported that headache can be seen in up to 40% of patients that are found to have transient global amnesia. CT/MRI findings are typically normal, however some patients are found to have small punctate lesions in the hippocampus on MRI, as we saw in this patient. It is important to rule out other possible causes of anterograde amnesia prior to making this diagnosis. Stroke, infection, seizures, metabolic or toxic encephalopathy, and other structural causes must be ruled out. Management of this condition is supportive therapy and close monitoring until the symptoms resolve. Patients should be counseled to follow-up with a neurologist in order to monitor for recurrence. Subsequent events are atypical and should be further evaluated to assess for other causes.
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