Transient global amnesia

Specialty: Neurology.

• acute loss of recent memory
• transient amnesic episode
• benign acute forgetfulness

Why it occurs

• Transient jugular venous congestion secondary to Valsalva maneuver, intense physical effort or sexual relations
• Transient focal ischemia in structures of the bilateral medial temporal lobe (hippocampus)
• Migrainous neuronal dysfunction (equivalent of migraine with hippocampal involvement)
• Extreme acute emotional stress or sudden immersion in cold water
• Subclinical epileptic activity located in the temporal lobe (transient epileptic amnesia, with typically shorter and recurrent episodes)

Initial workup

Comprehensive neurological examination during and after the episode (verify inability to retain new information with preservation of personal identity and long-term memory); Brain MRI with high-resolution diffusion protocol (DWI) focused on the hippocampus (typically shows small hyperintense punctate lesions 24-48 hours after the episode); electroencephalogram (EEG) to rule out temporary discharges.

Standard management

• It does not require specific pharmacological treatment, since by definition the condition resolves spontaneously in less than 24 hours (average of 6 hours) without cognitive sequelae.
• Acetylsalicylic acid (100 mg/day only if concomitant ischemic cerebrovascular pathology is demonstrated on imaging studies).