Amnesia history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
It is critical to perform a formal and exhaustive assessment of the patient to look for any indications of memory disorders and to hear any subjective complaints. With this information, preventative measures and care can be specifically addressed to the patient's needs.
History
Medical history questions may include:
- Type
- Can the person remember recent events (is there impaired short-term memory)?
- Can the person remember events from further in the past (is there impaired long-term memory)?
- Is there a loss of memory about events that occurred before a specific experience (anterograde amnesia)?
- Is there a loss of memory about events that occurred soon after a specific experience (retrograde amnesia)?
- Is there only a minimal loss of memory?
- Does the person make up stories to cover gaps in memory (confabulation)?
- Is the person suffering from low moods that impair concentration?
- Time pattern
- Has the memory loss been getting worse over the years?
- Has the memory loss been developing over weeks or months?
- Is the memory loss present all the time or are there distinct episodes of amnesia?
- If there are amnesia episodes, how long do they last?
- Aggravating or triggering factors
- Has there been a head injury in the recent past?
- Has the person experienced an event that was emotionally traumatic?
- Has there been a surgery or procedure requiring general anesthesia?
- Does the person use alcohol? How much?
- Does the person use illicit drugs? How much? What type?
- Other symptoms
- What other symptoms does the person have?
- Is the person confused or disoriented?
- Can they independently eat, dress, and perform similar self-care activities?
- Have they had seizures?
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. Symptoms 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 may indicate a serious illness, particularly in older adults. 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.
- Early diagnosis of Alzheimer's disease is possible with thorough neuropsychological testing of cognitive impairment.[1]
Whether an individual suffers from memory loss is not solely decided based on symptoms. In order to diagnose the condition, a doctor will obtain a detailed medical history of the patient.
Anterograde Amnesia
Anterograde amnesiacs suffer differing degrees of impairment to different types of memories. Patients can often learn and remember how to do a new physical skill (e.g., playing the guitar, learning the words to a new song and then singing them, etc.) but not remember when they learned it. Such "how-to", motor skill learning (procedural memory) and its attendant behavioral conditioning and priming are collectively known as non-declarative memory, which appears to be unaffected by anterograde amnesia.
However, the condition tends to impair both episodic memory (the memory of events) and semantic memory (the memory of facts and general knowledge). For the most part, patients are unable to make new semantic or episodic memories. Yet the research at this time conflicts enough that consensus on this point has not been reached: some patients appear able to create new semantic memories, and young children with anterograde amnesia seem to have semantic learning capabilities similar to non-amnesiacs.
Transient Global Amnesia
TGA does produce an inability to assimilate certain, generally current or recent, details while social skills and memories of distant past events or trivia is maintained. The requirements for TGA include: [2]
- The attack was witnessed and reported as being a definite loss of recent memory (anterograde amnesia).
- There was an absence of clouding of consciousness.
- There were no focal neurological signs or deficits during or after the attack.
- There were no features of epilepsy, and the patient did not have any recent head injury or active epilepsy.
- The attack resolved within 24 hours.
Symptoms typically last for less than a day and there is often no clear precipitating factor nor any other neurological deficits. Patients are typically amnestic of events more than a few minutes in the past, though immediate recall is usually preserved.
References
- ↑ Bäckman L, Jones S, Berger AK, Laukka EJ, Small BJ (2004). "Multiple cognitive deficits during the transition to Alzheimer's disease". J Intern Med. 256 (3): 195–204. doi:10.1111/j.1365-2796.2004.01386.x. PMID 15324363.
- ↑ Hodges JR, Warlow CP Syndromes of transient amnesia: towards a classification; a study of 153 cases. Neurosurg Psychiatry 1990;53:834–43