![]() ![]() 7 No laboratory investigations or imaging modality can confirm the diagnosis of TGA. The alarming symptoms often culminate in an emergency department (ED) visit with the incidence ranging from 3–10 per 100,000 patients per year. 5, 6 Recent magnetic resonance imaging (MRI) data on individuals following an episode of TGA show development of small hippocampal lesions as a result of increased vulnerability of selective neurons from metabolic stress, further supporting the postulation that TGA is triggered by transitory “stress-induced inhibition of memory formation in the hippocampus.” 4 TGA occurs in men and women equally with a mean age of 50–70 years. Recently, a growing body of evidence supports the role of emotional and psychological factors as precipitating events in up to 90% of reported TGA cases. 2 Diagnostic criteria for TGA demand that there be “no clouding of consciousness, other impairments of cognition, or a history of epilepsy or head trauma.” 3 Several studies have postulated that the mechanisms of TGA are comparable to processes underlying “cerebral ischemia, epilepsy, and migraines, or may arise from disturbance of venous hemodynamics.” 4 Yet more than a century after it was first described, there is no definitive evidence supporting any of these mechanisms. Transient global amnesia (TGA) is an acute-onset clinical entity typified by an abrupt and transient anterograde amnesia, “with repetitive questioning and often variable retrograde amnesia persisting up to 24 hours.” 1, 2 Inherent to the diagnosis of TGA is the preservation of neurologic functioning including procedural memory (ability to remember and apply a series of steps to a task). ![]() This is the third case of TGA attributed to nephrolithiasis in the medical literature. He experienced a complete resolution of symptoms within a 24-hour period, with a discharge diagnosis of TGA secondary to nephrolithiasis. Subsequently, the patient developed repetitive questioning and perseveration with anterograde amnesia with a negative CT brain and unremarkable further workup. Pain control proved difficult, necessitating multiple doses of opioid and non-opioid analgesia. ![]() Computed tomography (CT) of the abdomen/pelvis revealed a three-millimeter left ureterovesicular-junction calculus. Transient global amnesia (TGA) is typified by an abrupt and transient anterograde amnesia, “with repetitive questioning and often variable retrograde amnesia persisting up to 24 hours.” A 54-year-old male presented to our emergency department with paroxysms of left-sided flank pain, suggestive of renal colic. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |