Memory loss resident survival guide: Difference between revisions
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==Overview== | ==Overview== | ||
[[Amnesia]] is a condition in which [[memory]] is disturbed or lost. The causes of [[amnesia]] can be organic or functional. Organic causes include damage to the [[brain]] through [[trauma]] or disease or the use of certain (generally [[sedative]]) [[drugs]]. Functional causes are psychological factors, such as [[defense mechanisms]]. Hysterical [[Post traumatic stress disorder|post-traumatic]] [[amnesia]] is an example of this. [[Amnesia]] may also be spontaneous, in the case of [[transient global amnesia]]. This [[Global amnesia|global type of amnesia]] is more common in [[Middle age|middle-aged]] to elderly people, particularly males, and usually lasts less than 24 hours. [[Memory loss]] can be partial or total and is normally expected as we get older. | [[Amnesia]] is a condition in which [[memory]] is disturbed or lost. The causes of [[amnesia]] can be organic or functional. Organic causes include damage to the [[brain]] through [[trauma]] or disease or the use of certain (generally [[sedative]]) [[drugs]]. Functional causes are psychological factors, such as [[defense mechanisms]]. Hysterical [[Post traumatic stress disorder|post-traumatic]] [[amnesia]] is an example of this. [[Amnesia]] may also be spontaneous, in the case of [[transient global amnesia]]. This [[Global amnesia|global type of amnesia]] is more common in [[Middle age|middle-aged]] to elderly people, particularly males, and usually lasts less than 24 hours. [[Memory loss]] can be partial or total and is normally expected as we get older. | ||
* Life-threatening causes include conditions that may result in [[Dead body|death]] or permanent [[disability]] within 24 hours if left untreated. Most acute causes of [[amnesia]] are considered life-threatening, among them, are the following: | <br /> | ||
==Causes== | |||
===Life Threatening Causes=== | |||
*Life-threatening causes include conditions that may result in [[Dead body|death]] or permanent [[disability]] within 24 hours if left untreated. Most acute causes of [[amnesia]] are considered life-threatening, among them, are the following: | |||
**[[Electrolyte imbalance|Electrolyte imbalances]] | **[[Electrolyte imbalance|Electrolyte imbalances]] | ||
**[[Head trauma]] | **[[Head trauma]] | ||
| Line 13: | Line 15: | ||
**[[Intoxication|Intoxications]] | **[[Intoxication|Intoxications]] | ||
=== Common Causes=== | ===Common Causes=== | ||
**[[Alzheimer's disease|Alzheimer disease]]. | **[[Alzheimer's disease|Alzheimer disease]]. | ||
**[[Vascular dementia]] | **[[Vascular dementia]] | ||
**[[Frontotemporal dementia]] | **[[Frontotemporal dementia]] | ||
| Line 21: | Line 23: | ||
**[[Depression]] | **[[Depression]] | ||
<br /> | |||
==Diagnosis== | ==Diagnosis== | ||
Shown below is an [[algorithm]] summarizing the diagnosis of [[amnesia]] according to the the American Academy of Neurology guidelines:<ref name="pmid24459411">{{cite journal |vauthors=Jahn H |title=Memory loss in Alzheimer's disease |journal=Dialogues Clin Neurosci |volume=15 |issue=4 |pages=445–54 |date=December 2013 |pmid=24459411 |pmc=3898682 |doi= |url=}}</ref><ref name="urlInitial Evaluation of the Patient with Suspected Dementia - American Family Physician" /> | |||
<br />{{familytree/start |summary=PE diagnosis Algorithm.}} | |||
{{familytree/start |summary=PE diagnosis Algorithm.}} | |||
{{familytree | | | | | | | | A01 |A01= Patient with [[amnesia]]}} {{familytree | | | | |,|-|-|-|^|-|-|-|-|.| | | }} | {{familytree | | | | | | | | A01 |A01= Patient with [[amnesia]]}} {{familytree | | | | |,|-|-|-|^|-|-|-|-|.| | | }} | ||
{{familytree | | | B01 | | | | | | | | B02 | | |B01= Acute onset|B02= Chronic onset}} | {{familytree | | | B01 | | | | | | | | B02 | | |B01= Acute onset|B02= Chronic onset}} | ||
| Line 69: | Line 70: | ||
| B04= [[Dementia with Lewy bodies]] | | B04= [[Dementia with Lewy bodies]] | ||
| B05= [[Parkinson disease dementia]]| }} | | B05= [[Parkinson disease dementia]]| }} | ||
{{familytree/end}} | {{familytree/end}}<br /> | ||
==Do's== | ==Do's== | ||
*Perform [[Laboratory|laboratory testing]] is to exclude potentially reversible causes of [[amnesia]]. Initial tests should include a [[CBC]], [[Toxicology screen|urine toxicology]], [[Thyroid function tests|thyroid function]], [[Folate deficiency|folate]], and [[vitamin B12]] level.<ref name="urlInitial Evaluation of the Patient with Suspected Dementia - American Family Physician" /> | *Perform [[Laboratory|laboratory testing]] is to exclude potentially reversible causes of [[amnesia]]. Initial tests should include a [[CBC]], [[Toxicology screen|urine toxicology]], [[Thyroid function tests|thyroid function]], [[Folate deficiency|folate]], and [[vitamin B12]] level.<ref name="urlInitial Evaluation of the Patient with Suspected Dementia - American Family Physician" /> | ||
*When a history of [[head trauma]] exists, perform an immediate [[CT scan|non-contrasted CT scan]] of the head to rule out intracerebral hemorrage. [[Neuroimaging]] may diagnose [[vascular disease]], [[normal pressure hydrocephalus]], [[tumors]], [[abscess]].<ref name="pmid11342678">{{cite journal |vauthors=Knopman DS, DeKosky ST, Cummings JL, Chui H, Corey-Bloom J, Relkin N, Small GW, Miller B, Stevens JC |title=Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology |journal=Neurology |volume=56 |issue=9 |pages=1143–53 |date=May 2001 |pmid=11342678 |doi=10.1212/wnl.56.9.1143 |url=}}</ref> | *When a history of [[head trauma]] exists, perform an immediate [[CT scan|non-contrasted CT scan]] of the head to rule out intracerebral hemorrage. [[Neuroimaging]] may diagnose [[vascular disease]], [[normal pressure hydrocephalus]], [[tumors]], [[abscess]].<ref name="pmid11342678">{{cite journal |vauthors=Knopman DS, DeKosky ST, Cummings JL, Chui H, Corey-Bloom J, Relkin N, Small GW, Miller B, Stevens JC |title=Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology |journal=Neurology |volume=56 |issue=9 |pages=1143–53 |date=May 2001 |pmid=11342678 |doi=10.1212/wnl.56.9.1143 |url=}}</ref> | ||
*Perform a minimental status test on [[physical examination]] and pay especial attention in [[concentration]] domain. Minimental testing has the potential distinguish mild [[cognitive impairment]] from [[dementia]].<ref name="pmid11342677">{{cite journal |vauthors=Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST |title=Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology |journal=Neurology |volume=56 |issue=9 |pages=1133–42 |date=May 2001 |pmid=11342677 |doi=10.1212/wnl.56.9.1133 |url=}}</ref> | *Perform a minimental status test on [[physical examination]] and pay especial attention in [[concentration]] domain. Minimental testing has the potential distinguish mild [[cognitive impairment]] from [[dementia]].<ref name="pmid11342677">{{cite journal |vauthors=Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST |title=Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology |journal=Neurology |volume=56 |issue=9 |pages=1133–42 |date=May 2001 |pmid=11342677 |doi=10.1212/wnl.56.9.1133 |url=}}</ref> | ||
*Always have in mind [[depression]] as a possible causant of [[Amnesia|memory impairmant]]. [[Depression]] is common cause of [[amnesia]]; a SIGE CAPS evaluation may disclose an underlying [[mood disorder]].<ref name="pmid32356472">{{cite journal |vauthors=Squire LR, Zouzounis JA |title=Self-ratings of memory dysfunction: different findings in depression and amnesia |journal=J Clin Exp Neuropsychol |volume=10 |issue=6 |pages=727–38 |date=December 1988 |pmid=3235647 |doi=10.1080/01688638808402810 |url=}}</ref> | *Always have in mind [[depression]] as a possible causant of [[Amnesia|memory impairmant]]. [[Depression]] is common cause of [[amnesia]]; a SIGE CAPS evaluation may disclose an underlying [[mood disorder]].<ref name="pmid32356472">{{cite journal |vauthors=Squire LR, Zouzounis JA |title=Self-ratings of memory dysfunction: different findings in depression and amnesia |journal=J Clin Exp Neuropsychol |volume=10 |issue=6 |pages=727–38 |date=December 1988 |pmid=3235647 |doi=10.1080/01688638808402810 |url=}}</ref> | ||
<br /> | |||
==Don'ts== | ==Don'ts== | ||
*If [[alcoholism]] and [[thiamine deficiency]] is suspected, do not administer [[glucose]] before [[thiamine]]. Administration of [[glucose]] before [[thiamine]] may lead to [[Wernicke's encephalopathy|Wernicke encephalopathy]].<ref name="urlThiamine Before Glucose to Prevent Wernicke Encephalopathy: Examining the Conventional Wisdom | JAMA | JAMA Network">{{cite web |url=https://jamanetwork.com/journals/jama/article-abstract/2682749#:~:text=%E2%80%94In%20his%20letter%2C%20Dr%20Marinella,statement%20describes%20only%204%20patients. |title=Thiamine Before Glucose to Prevent Wernicke Encephalopathy: Examining the Conventional Wisdom | JAMA | JAMA Network |format= |work= |accessdate=}}</ref> | *If [[alcoholism]] and [[thiamine deficiency]] is suspected, do not administer [[glucose]] before [[thiamine]]. Administration of [[glucose]] before [[thiamine]] may lead to [[Wernicke's encephalopathy|Wernicke encephalopathy]].<ref name="urlThiamine Before Glucose to Prevent Wernicke Encephalopathy: Examining the Conventional Wisdom | JAMA | JAMA Network">{{cite web |url=https://jamanetwork.com/journals/jama/article-abstract/2682749#:~:text=%E2%80%94In%20his%20letter%2C%20Dr%20Marinella,statement%20describes%20only%204%20patients. |title=Thiamine Before Glucose to Prevent Wernicke Encephalopathy: Examining the Conventional Wisdom | JAMA | JAMA Network |format= |work= |accessdate=}}</ref> | ||
<br /> | |||
==References== | ==References== | ||
{{Reflist|2}} {{WikiDoc Help Menu}} {{WikiDoc Sources}} | {{Reflist|2}} {{WikiDoc Help Menu}} {{WikiDoc Sources}} | ||
Revision as of 06:04, 6 September 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo, M.D.
Overview
Amnesia is a condition in which memory is disturbed or lost. The causes of amnesia can be organic or functional. Organic causes include damage to the brain through trauma or disease or the 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. 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 is normally expected as we get older.
Causes
Life Threatening Causes
- Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated. Most acute causes of amnesia are considered life-threatening, among them, are the following:
Common Causes
Diagnosis
Shown below is an algorithm summarizing the diagnosis of amnesia according to the the American Academy of Neurology guidelines:[1][2]
Do's
- Perform laboratory testing is to exclude potentially reversible causes of amnesia. Initial tests should include a CBC, urine toxicology, thyroid function, folate, and vitamin B12 level.[2]
- When a history of head trauma exists, perform an immediate non-contrasted CT scan of the head to rule out intracerebral hemorrage. Neuroimaging may diagnose vascular disease, normal pressure hydrocephalus, tumors, abscess.[3]
- Perform a minimental status test on physical examination and pay especial attention in concentration domain. Minimental testing has the potential distinguish mild cognitive impairment from dementia.[4]
- Always have in mind depression as a possible causant of memory impairmant. Depression is common cause of amnesia; a SIGE CAPS evaluation may disclose an underlying mood disorder.[5]
Don'ts
- If alcoholism and thiamine deficiency is suspected, do not administer glucose before thiamine. Administration of glucose before thiamine may lead to Wernicke encephalopathy.[6]
References
- ↑ Jahn H (December 2013). "Memory loss in Alzheimer's disease". Dialogues Clin Neurosci. 15 (4): 445–54. PMC 3898682. PMID 24459411.
- ↑ 2.0 2.1 Invalid
<ref>tag; no text was provided for refs namedurlInitial Evaluation of the Patient with Suspected Dementia - American Family Physician - ↑ Knopman DS, DeKosky ST, Cummings JL, Chui H, Corey-Bloom J, Relkin N, Small GW, Miller B, Stevens JC (May 2001). "Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology". Neurology. 56 (9): 1143–53. doi:10.1212/wnl.56.9.1143. PMID 11342678.
- ↑ Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST (May 2001). "Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology". Neurology. 56 (9): 1133–42. doi:10.1212/wnl.56.9.1133. PMID 11342677.
- ↑ Squire LR, Zouzounis JA (December 1988). "Self-ratings of memory dysfunction: different findings in depression and amnesia". J Clin Exp Neuropsychol. 10 (6): 727–38. doi:10.1080/01688638808402810. PMID 3235647.
- ↑ "Thiamine Before Glucose to Prevent Wernicke Encephalopathy: Examining the Conventional Wisdom | JAMA | JAMA Network".