Miller, Thomas; Butler, Christopher; (2022) Acute-onset amnesia: transient global amnesia and other causes. Practical Neurology (In press).

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Abstract

Acute-onset amnesia is a dramatic neurological presentation that can cause considerable concern to both patient and clinician. The patient typically presents with an inability to not only retain new memories but also access previously acquired memories, suggesting disturbance of hippocampal function. Transient global amnesia (TGA) is most common cause of acute-onset amnesia and is characterized by a profound anterograde and retrograde amnesia that typically lasts for <24 hours. Whilst the presentation of TGA is strikingly stereotypical, it can be challenging to distinguish between TGA and other similar differential diagnoses (including posterior circulation strokes, transient epileptic amnesia, psychogenic amnesia, post-traumatic amnesia, and toxic/drug-related amnesia). In this article, we describe the general approach to the acutely amnesic patient; summarise the clinical and neuropsychological differences between the potential causes; and provide practical recommendations to aid diagnosis and management of acute amnesia. Regardless of cause and the dramatic presentation, the prognosis of non-ischaemic acute-onset amnesia is generally favourable.

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