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| '''For patient information click [[Amnesia (patient information)|here]]''' | | __NOTOC__ |
| | {{Amnesia}} |
| | '''For patient information, click [[Amnesia (patient information)|here]]''' |
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| {{Infobox_Disease | | | {{CMG}}; {{AE}} {{ZMalik}} |
| Name = {{PAGENAME}} |
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| Image = |
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| Caption = |
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| DiseasesDB = |
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| ICD10 = {{ICD10|R|41|3|r|40}} |
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| ICD9 = {{ICD9|780.9}}, {{ICD9|780.93}} |
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| ICDO = |
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| OMIM = |
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| MedlinePlus = 003257 |
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| eMedicineSubj = |
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| eMedicineTopic = |
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| MeshID = D000647 |
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| }}
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| {{SI}}
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| {{CMG}} ; '''Angela Botts''', M.D., Beth Israel Deaconess Medical Center Geriatric Medicine ; {{ADI}}
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| ==Overview==
| | {{SK}} Amnestic; amnestic disorder; amnestic syndrome; blackout; memory loss; forgetfulness; impaired memory |
| '''Amnesia''' (from [[Greek language|Greek]] ''{{polytonic|Ἀμνησία}}'') is a condition in which [[memory]] is disturbed. The causes of amnesia are organic or functional. In simple terms it is the loss of memory. Organic causes include damage to the brain, through trauma or disease, or 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]]<ref>[http://www.emedicine.com/neuro/topic380.htm eMedicine - Transient Global Amnesia : Article by Roy Sucholeiki<!-- Bot generated title -->]</ref>. 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 it is normal when it comes with [[Ageing|aging]].
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| Another effect of amnesia is the inability to imagine the future. A recent study published online in the ''[[Proceedings of the National Academy of Sciences]]'' shows that amnesiacs with damaged [[hippocampus|hippocampus]] cannot imagine the future[http://www.pnas.org/cgi/content/abstract/0610561104v1]. This is because when a normal human being imagines the future, they use their past experiences to construct a possible scenario. For example, a person who would try to imagine what would happen at a party that would occur in the near future would use their past experience at parties to help construct the event in the future.
| | == [[Amnesia overview|Overview]] == |
| | ==[[Amnesia historical perspective|Historical Perspective]]== |
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| | == [[Amnesia classification|Classification]] == |
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| ==Forms of amnesia== | | == [[Amnesia pathophysiology|Pathophysiology]] == |
| * In '''[[anterograde amnesia]]''', new events contained in the immediate memory are not transferred to the permanent as long-term memory. The sufferer will not be able to remember anything that occurs after the onset of this type of amnesia for more than a brief period following the event.
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| * '''[[Retrograde amnesia]]''' is the inability to recall some memory or memories of the past, beyond ordinary forgetfulness.
| | == [[Amnesia causes|Causes]] == |
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| :The terms are used to categorize patterns of symptoms, rather than to indicate a particular cause or [[etiology]]. Both categories of amnesia can occur together in the same patient, and commonly result from drug effects or damage to the brain regions most closely associated with [[episodic memory|episodic]]/[[declarative memory]]: the medial [[temporal lobe]]s and especially the [[hippocampus]].
| | == [[Amnesia differential diagnosis|Differentiating Amnesia from other Diseases]] == |
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| :An example of mixed retrograde and anterograde amnesia may be a motorcyclist unable to recall driving his motorbike prior to his head injury (retrograde amnesia), nor can he recall the hospital ward where he is told he had conversations with family over the next two days (anterograde amnesia).
| | == [[Amnesia epidemiology and demographics|Epidemiology and Demographics]] == |
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| ==Types of amnesia== | | == [[Amnesia risk factors|Risk Factors]] == |
| * '''[[Post-traumatic amnesia]]''' is generally due to a [[traumatic brain injury|head injury]] (e.g. a fall, a knock on the head). Traumatic amnesia is often transient, but may be permanent of either anterograde, retrograde, or mixed type. The extent of the period covered by the amnesia is related to the degree of injury and may give an indication of the prognosis for recovery of other functions. [[Mild traumatic brain injury|Mild trauma]], such as a car accident that results in no more than mild whiplash, might cause the occupant of a car to have no memory of the moments just before the accident due to a brief interruption in the short/long-term memory transfer mechanism. The sufferer may also lose knowledge of who people are, they may remember events, but will not remember faces of them.
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| *'''[[Psychogenic amnesia|Dissociative Amnesia]]''' results from a psychological cause as opposed to direct damage to the brain caused by head injury, physical trauma or disease, which is known as organic amnesia. [[Psychogenic amnesia|Dissociative Amnesia]] can include:
| | == [[Amnesia natural history, complications and prognosis|Natural History, Complications and Prognosis]] == |
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| :*'''[[Repressed memory]]''' refers to the inability to recall information, usually about stressful or traumatic events in persons' lives, such as a violent attack or rape. The memory is stored in long term memory, but access to it is impaired because of psychological defense mechanisms. Persons retain the capacity to learn new information and there may be some later partial or complete recovery of memory. This contrasts with e.g. anterograde amnesia caused by amnestics such as benzodiazepines or alcohol, where an experience was prevented from being transferred from temporary to permanent memory storage: it will never be recovered, because it was never stored in the first place. Formerly known as "Psychogenic Amnesia"
| | ==Diagnosis== |
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| :*'''[[Fugue state|Dissociative Fugue]]''' (''formerly'' Psychogenic Fugue) is also known as fugue state. It is caused by psychological trauma and is usually temporary, unresolved and therefore may return. The [[Merck Manual]] defines it as "one or more episodes of amnesia in which the inability to recall some or all of one's past and either the loss of one's identity or the formation of a new identity occur with sudden, unexpected, purposeful travel away from home" [http://www.merck.com/mrkshared/mmanual/section15/chapter188/188c.jsp]. While popular in fiction, it is extremely rare.
| | [[Amnesia diagnostic criteria|Diagnostic Criteria]] | [[Amnesia history and symptoms|History and Symptoms]] | [[Amnesia physical examination|Physical Examination]] | [[Amnesia laboratory findings|Laboratory Findings]] | [[Amnesia electrocardiogram|Electrocardiogram]] | [[Amnesia CT|CT]] | [[Amnesia MRI|MRI]] | [[Amnesia other imaging findings|Other Imaging Findings]] | [[Amnesia other diagnostic studies|Other Diagnostic Studies]] |
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| :* '''Posthypnotic amnesia''' is where events during [[hypnosis]] are forgotten, or where past memories are unable to be recalled.
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| :* '''[[Lacunar amnesia]]''' is the loss of memory about one specific event.
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| :* '''[[Childhood amnesia]]''' (also known as infantile amnesia) is the common inability to remember events from one's own childhood. Whilst [[Sigmund Freud]] attributed this to sexual repression, others have theorised that this may be due to [[language development]] or immature parts of the brain.
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| * '''[[Transient global amnesia]]''' is a well-described medical and clinical phenomenon. This form of amnesia is distinct in that abnormalities in the [[hippocampus]] can sometimes be visualized using a special form of [[magnetic resonance imaging]] of the brain known as [[diffusion-weighted imaging]] (DWI). Symptoms typically last for less than a day and there is often no clear precipitating factor nor any other neurological deficits. The cause of this syndrome is not clear, hypotheses include transient reduced blood flow, possible seizure or an atypical type of migraine. Patients are typically amnestic of events more than a few minutes in the past, though immediate recall is usually preserved.
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| *'''[[Source amnesia]]''' is a memory disorder in which someone can recall certain information, but they do not know where or how they obtained the information.
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| *'''[[Memory distrust syndrome]]''' is a term invented by the psychologist [[Gisli Gudjonsson]] to describe a situation where someone is unable to trust their own memory.
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| *'''[[Blackout (Alcohol Related Amnesia)|Blackout phenomenon]]''' can be caused by excessive short-term alcohol consumption, with the amnesia being of the anterograde type.
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| *'''[[Korsakoff's syndrome]]''' can result from long-term alcoholism or malnutrition. It is caused by brain damage due to a Vitamin B1 deficiency and will be progressive if alcohol intake and nutrition pattern are not modified. Other neurological problems are likely to be present in combination with this type of Amnesia. Korsakoff's syndrome is also known to be connected with [[confabulation]].
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| ==Symptoms==
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| Symptoms of memory loss vary from person to person, but can include: forgetting dates and names; beginning a task but then forgetting the purpose of it; getting lost easily; repeating things over and over again, sometimes in the same conversation; and having difficulties performing familiar tasks such as driving or baking. They usually occur gradually and may vary in intensity depending on the cause of the condition.
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| Confusion or decreased [[alertness]] may be the first symptom of memory loss and also of serious illness, particularly in older adults.<ref>[http://health.yahoo.com/alzheimers-overview/confusion-memory-loss-and-altered-alertness/healthwise--confu.htmlConfusion, Memory Loss, and Altered Alertness]Retrieved on 2010-03-10</ref>
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| The most worrisome symptoms are not those related to things that people forget to do.{{Opinion|date=February 2012}} Some patients may have problems mixing up or remembering words for objects or can have trouble understanding or taking part in a conversation. Being unable to make a simple decision can suggest that something is not working as it should and [[medical advice]] should be sought.
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| Whether an individual suffers from memory loss is not decided only based on one's symptoms. In order to diagnose the condition a doctor will obtain a detailed medical history of the patient. The patient will also undergo several [[Neuropsychology|neuropsychological]]tests that will focus on his or her memory functions. Several other medical exams such as an[[electroencephalography]], an [[Magnetic resonance imaging|MRI]], or a [[X-ray computed tomography|CT scan]] can be performed in order to establish an accurate diagnosis.
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| The main type of memory loss is [[short-term memory]]. Short-term memory refers to memories that last for a few minutes .
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| ==Differential diagnosis==
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| *Side effects of Medication: Many drugs can cause cognitive problems and memory loss as a side effects, common in adults. Common drugs that affect memory and brain function include sleeping pills, antihistamines, blood pressure and arthritis medication, antidepressants, anti-anxiety medications, and painkillers.
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| *Depression: Depression mimics the signs of memory loss. It is a common problem in older adults—especially if one is less social and active than they used to be or if one has recently experienced a number of major life changes (retirement, a serious medical diagnosis, the loss of a loved one, moving away from home).
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| *Vitamin B12 Deficiency: Vitamin B12 protects neurons and is vital to healthy brain functioning. A lack of B12 can cause permanent damage to the brain.
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| ===Common causes===
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| ===Organ system based===
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| {|style="width:80%; height:100px" border="1"
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| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
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| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Chemical / poisoning'''
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| |bgcolor="Beige"| No underlying causes
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| | '''Dermatologic'''
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| |bgcolor="Beige"| No underlying causes
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| | '''Drug Side Effect'''
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| |bgcolor="Beige"| No underlying causes
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| | '''Ear Nose Throat'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Endocrine'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Environmental'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Gastroenterologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Genetic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Hematologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Iatrogenic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Infectious Disease'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Musculoskeletal / Ortho'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Neurologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Nutritional / Metabolic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue" | |
| | '''Obstetric/Gynecologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Oncologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Opthalmologic'''
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| |bgcolor="Beige"| No underlying causes
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| | '''Overdose / Toxicity'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Psychiatric'''
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| |bgcolor="Beige"| No underlying causes
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| | '''Pulmonary'''
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| |bgcolor="Beige"| No underlying causes
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| | '''Renal / Electrolyte'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Rheum / Immune / Allergy'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Sexual'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Trauma'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Urologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Dental'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Miscellaneous'''
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| |bgcolor="Beige"| No underlying causes
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| |}
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| ===Alphabetical order===
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| ==Prevention==
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| The most common preventable cause of memory loss is brain trauma, especially trauma resulting from [[head injury]]. Preventative measures such as wearing a seat belt while driving or a helmet while biking, can reduce the risk of head injury while participating in dangerous activities.<ref>[http://www.suddenmemoryloss.com/ Sudden Memory Loss Causes and Diagnosis] Retrieved on 2010-03-10</ref>
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| Eating [[nutrition|nutritious]] foods and reducing [[Stress (biology)|stress]] may help prevent memory loss. In addition, it may be helpful to avoid risk factors such as alcohol abuse and exposure to toxic chemicals. As [[hypertension|high blood pressure]] increases the risk for stroke, and therefore memory loss, blood pressure should be kept under control. Lifestyle adjustments such as smoking cessation and exercise can also further reduce the risk for stroke and brain trauma.
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| Some specialists recommend that patients drink enough [[water]] for better [[Rehydration|hydration]]. [[Sleep deprivation]] and stress are also thought to impact the proper functioning of the brain cells, so it is important to get enough rest and avoid stressful activities.
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| [[Socializing]] is also believed to be beneficial for individuals who may develop memory loss.<ref>{{cite web|url=http://www.healthynewage.com/memory.html| title=Information About Memory Loss - Causes, Symptoms and Supplementation|date=|accessdate= 2010-06-25}}</ref>
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| Patients who experience memory loss as a result of aging may keep their brain cells healthy and active with exercise and [[dietary supplements]]. However, although some dietary choices and lifestyle changes are suggested, it has not yet been proven to what extent these may reduce the risk of memory loss, especially that caused by aging. Dietary supplements that may be recommended include multivitamins and mineral complexes, [[boron]], [[lecithin]], [[garlic]], [[gingko]], [[vitamin B complex]], [[zinc]], [[copper]], [[acetylcholine]], DMAE, and [[vitamin C]] with [[bioflavonoid]].<ref>{{cite web|url=http://www.healthynewage.com/memory.html| title=Information About Memory Loss - Causes, Symptoms and Supplementation|date=|accessdate= 2010-06-25}}</ref><!-- [Removed the following as being unsourced, mostly duplicative of earlier portion of paragraph, and extremely poorly written (likely by a nonnative speaker of English).] Each of these supplements may help in a way or another in maintaining the cells of the brain vigorous and healthy. For instance, garlic is thought to be the brain cell protector and which is considered helpful in cases of memory loss caused by aging. Also, multivitamin and mineral complexes provide the necessary nutrients for the body and brain cells and remove the harmful [[free radicals]]. Lecithin is well known for its special properties of improving memory as well as boron, a substance that may enhance the memory function of the brain. Gingko and vitamin C with bioflavonoid are effective in increasing the [[blood flow]] to the brain which is in the end beneficial for the cells and therefore the memory.{{Citation needed|date=September 2011}}-->
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| Patients whose memory loss is bothersome to the extent that it becomes an issue are encouraged to establish a routine and follow it. Making lists and associations, keeping a detailed [[calendar]] as well as always putting important objects in the same place might also help them in remembering more easily and faster.<ref>{{cite web|url=http://familydoctor.org/online/famdocen/home/seniors/common-older/124.html| title=Memory Loss With Aging: What's Normal, What's Not|date=|accessdate= 2010-06-25}}</ref> It has been brought{{By whom|date=February 2012}} to attention{{whose?}} that people who develop mild symptoms of memory loss are more likely to prevent the worsening of the condition if they train their mind by playing [[strategy games]], [[puzzle]], [[word games]] or number puzzles and reading. Basically, stimulating the brain can help patients slow down the processes that cause memory loss.
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| Memory loss among seniors is not inevitable, but is a normal occurrence for many as the brain slows down. This is not the same thing as dementia. Mental functions to do normal activities you have always done, life experience, common sense, and the ability to form reasonable judgments and arguments are not affected.<ref>[http://helpguide.org/life/prevent_memory_loss.htm/]</ref>
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| Exercise, especially [[aerobic exercise]], helps combat or restore memory loss. Studies indicate that exercise lessens stress, increases blood flow, and stabilizes and deepens sleep patterns. Even walking a few times a week helps fight memory loss.<ref>[http://www.webmd.com/healthy-aging/features/7-brain-boosters-to-prevent-memory-loss/]</ref>
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| ==Treatment== | | ==Treatment== |
| Memory loss can't be treated unless it is caused by a reversible condition. The treatment is greatly dependent on the primary cause of the condition. When memory loss is a symptom of a more severe disease, it may be reversed as soon as the underlying condition is identified and cured. Memory loss due to aging cannot be cured, but the symptoms may be improved by following the prevention measures.
| | [[Amnesia medical therapy|Medical Therapy]] | [[Amnesia primary prevention|Primary Prevention]] | [[Amnesia cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Amnesia future or investigational therapies|Future or Investigational Therapies]] |
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| Treating mild cases of memory loss may consist of herbal medications or a change in lifestyle.<ref>{{cite web|url=http://www.suddenmemoryloss.net/treatment.html| title=Memory Loss Treatment|date=|accessdate= 2010-06-25}}</ref> The other dietary supplements along with good quality and long sleep and avoiding potential risk factors may also improve the general status of the patient.
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| Family support plays an important role in treating memory loss. Family members are usually encouraged to take special orientation classes on how to cope with their sick relatives and how to help them improve their condition.
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| ==Pathology==
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| The memory is affected by the damage that may occur in the different parts of the brain such as [[medial temporal lobe]], [[hippocampus]], cortex and frontal lobes. Injuring any of these areas may lead to specific disruptions in the processes of acquiring and restoring memory. For instance, damage to the medial temporal lobe and hippocampus can devastate the ability to acquire new [[declarative memory]] whereas damage to the storage areas in cortex can disrupt retrieval of old memories and interfere with acquisition of new memories.<ref>{{cite web|url=http://www.memorylossonline.com/glossary/memory.html| title=Memory|date=|accessdate= 2010-06-25}}</ref>
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| == See also ==
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| * [[Betrayal#Betrayal trauma|Betrayal Trauma]]
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| * [[Clive Wearing]]
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| * [[Emotion and memory]]
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| * [[False memory]]
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| * [[HM (patient)]]
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| * [[Doug Bruce]]
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| ==References== | | ==Case Studies== |
| {{reflist|2}}
| | [[Amnesia case study one|Case #1]] |
| | ==Related Chapters== |
| | * [[Emotion and memory|Emotion and Memory]] |
| | * [[False memory|False Memory]] |
| | * [[HM (patient)]] |
| | *[[Cognitive neuropsychology|Cognitive Neuropsychology]] |
| | *[[Korsakoff's syndrome|Korsakoff's Syndrome]] |
| | *[[Repressed memory|Repressed Memory]] |
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| | | [[Category:Emergency medicine]] |
| {{Cognition, perception, emotional state and behaviour symptoms and signs}}
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| [[Category:Memory disorders]] | |
| [[Category:Neurology]] | | [[Category:Neurology]] |
| [[Category:Psychiatry]] | | [[Category:Psychiatry]] |
| [[Category:Overview complete]] | | [[Category:Mature chapter]] |
| [[Category:Signs and symptoms]] | | [[Category:Memory disorders]] |
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