TGA is a well-described phenomenon that clinically manifests with a paroxysmal, transient loss of memory function. Immediate recall ability is preserved, as is remote memory; however, patients experience striking loss of memory for recent events and an impaired ability to retain new information. In some cases, the degree of retrograde memory loss is mild.
Many mechanisms have been proposed, but no single cause can explain fully all the features of TGA. These mechanisms include migraine variant, temporal lobe seizure, and transient ischemic attack. If a patient is young or has repeated attacks, then the possibility of seizure or even migraine is higher. An association between migraine and TGA has been established. In one nationwide cohort study, migraine was associated with an increased risk for TGA, particularly in female patients aged 40-60 years.
Upon mental status examination, language function is preserved, which indicates a preservation of semantic and syntax memory. Attention is spared, visuospatial skills are intact, and social skills are retained. Symptoms typically last less than 24 hours.
Patient who have significant risk factors for stroke along with features of TGA should receive an imaging test to rule out stroke. MRI with diffusion weighted imaging can readily demonstrate acute ischemic changes early and guide management. If an MRI cannot be readily obtained, then CT should be initially performed if the patient is presenting to an emergency department.
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Cite this: Helmi L. Lutsep. Fast Five Quiz: Memory Loss - Medscape - Apr 10, 2019.