Amnesia: Difference between revisions
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{{CMG}} ; {{ADI}} | {{CMG}} ; '''Angela Botts''', M.D., Beth Israel Deaconess Medical Center Geriatric Medicine ; {{ADI}} | ||
==Overview== | ==Overview== | ||
'''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. | '''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]]. | ||
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. | 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. | ||
==Forms of amnesia== | ==Forms of amnesia== | ||
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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]]. | *'''[[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]]. | ||
==Symptoms== | |||
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. | |||
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> | |||
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. | |||
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. | |||
The main type of memory loss is [[short-term memory]]. Short-term memory refers to memories that last for a few minutes . | |||
==Differential diagnosis== | ==Differential diagnosis== | ||
*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. | |||
*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). | |||
*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. | |||
Revision as of 17:29, 13 July 2012
For patient information click here
| Amnesia | |
| ICD-10 | R41.3 |
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| ICD-9 | 780.9, 780.93 |
| MedlinePlus | 003257 |
| MeSH | D000647 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Angela Botts, M.D., Beth Israel Deaconess Medical Center Geriatric Medicine ; Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
Amnesia (from Greek Template:Polytonic) 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[1]. 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 aging.
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 cannot imagine the future[3]. 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.
Forms of amnesia
- 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.
- Retrograde amnesia is the inability to recall some memory or memories of the past, beyond ordinary forgetfulness.
- 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/declarative memory: the medial temporal lobes and especially the hippocampus.
- 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).
Types of amnesia
- Post-traumatic amnesia is generally due to a 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 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.
- 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. Dissociative Amnesia can include:
- 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"
- 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" [4]. While popular in fiction, it is extremely rare.
- Posthypnotic amnesia is where events during hypnosis are forgotten, or where past memories are unable to be recalled.
- Lacunar amnesia is the loss of memory about one specific event.
- 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.
- 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.
- 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.
- 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.
- Blackout phenomenon can be caused by excessive short-term alcohol consumption, with the amnesia being of the anterograde type.
- 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.
Symptoms
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.
Confusion or decreased alertness may be the first symptom of memory loss and also of serious illness, particularly in older adults.[2]
The most worrisome symptoms are not those related to things that people forget to do.Template:Opinion 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.
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 neuropsychologicaltests that will focus on his or her memory functions. Several other medical exams such as anelectroencephalography, an MRI, or a CT scan can be performed in order to establish an accurate diagnosis.
The main type of memory loss is short-term memory. Short-term memory refers to memories that last for a few minutes .
Differential diagnosis
- 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.
- 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).
- 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.
Common causes
Organ system based
| Cardiovascular | No underlying causes |
| Chemical / poisoning | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | No underlying causes |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | No underlying causes |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional / Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal / Electrolyte | No underlying causes |
| Rheum / Immune / Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Dental | No underlying causes |
| Miscellaneous | No underlying causes |
Alphabetical order
See also
References
- ↑ eMedicine - Transient Global Amnesia : Article by Roy Sucholeiki
- ↑ Memory Loss, and Altered AlertnessRetrieved on 2010-03-10
Template:Cognition, perception, emotional state and behaviour symptoms and signs
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