The Brief Disturbing Experience of Transient Global Amnesia Losing your memory for a day is something you will never forget

Magazine editor John Birmingham was shocked to find his wife Lola – dressed for work and for a birthday party afterwards, in a jacket with a large cloth flower – on the edge of their bed, peering at her outfit in bewilderment. .

“Why am I dressed like that?” she kept asking.

“You have to go to a party after work,” he replied.

“But… what should I do?”

Then John got scared. His wife owned a small business that made unique hats using handmade materials; she was passionately committed to her work.

“She kept asking me where I was, where I had been. Then she said, “And what are you doing?” Very chill. I thought, okay, take her to the hospital.”

At Mount Sinai Beth Israel Hospital, doctors peppered Lola with cognitive tests: Did she know her name? The year? The current president?

“Hillary Clinton?” she suspected. The doctor smiled. “Not yet.”

Finally, a neurologist diagnosed transient global amnesia (TGA), an episode of sudden and short-term forgetting that most commonly occurs in people between the ages of 50 and 70. It affects between three and eight in every 100,000 people each year.

The main symptom of TGA is anterograde amnesia, or the inability to form and retain new memories. “[TGA patients] can only hold the world in their brains for 5 minutes or so,” explains Nancy Sicotte, MD, chair of the Division of Neurology at Cedars-Sinai in Los Angeles. “They are very confused. The hallmark is repeatedly the question: ‘Where am I? What is going on? What’s going on?’” Some people with TGA also lose old memories, although they retain their own identity and can walk, speak, and do other tasks. “They may not recognize someone they’ve only been married to for two or three years,” Sicotte says.

The episodes usually last between 4 and 6 hours, although they can last as long as 24 hours. They get better on their own, with older memories returning first. Only the actual period of the TGA remains a number.

Lola, 74, remembers getting dressed that spring morning in 2015. “Before I knew it, I woke up in the emergency room with no idea what was going on. It felt very much like a dream. I remember seeing a clock. I thought: is it night? Is it day? And where am I?”

While an episode of TGA is deeply distressing to patients — and to their loved ones, who may fear a stroke or brain tumor as the cause — neurologists consider it a “benevolent syndrome” with no long-term effects.

About 80% of patients never relapse, says Steven L. Lewis, MD, chief of neurology at Lehigh Valley Health Network and editor of Continuum: Lifelong Learning in Neurology. The remaining 20% ​​can have one or two more attacks for their entire life. A 2020 study published in JAMA Neurology found that TGA patients with a higher personal and family history of migraine were more likely to get it again.

Neurologists don’t yet know exactly how TGA happens, but research points to brief venous hypertension in the brain. This temporarily deprives the brain’s two memory-forming hippocampuses of oxygen. “What we don’t understand is exactly what happens on a physiological level,” Sicotte says. “There is a decrease in blood flow, but why?”

Doctors do know that TGA episodes usually have a trigger: a sudden dip in warm or cold water; extreme physical exertion; a severe emotional shock; sexual intercourse.

That’s what happened to Joan Lang, 65, one afternoon 9 years ago. She and her husband were hugging in post-coital bliss at their home in Portland, ME, when she suddenly asked when they planned to put their boat in the water for the season.

They had sold the boat the previous summer to a man named Forest.

“I had no memory of that,” Joan says. She barely remembers the car ride to Mercy Hospital, where, according to her husband, she asked again and again, “What happened to me?”

Hospitalized overnight: ‘I had one of the strangest nights I’ve ever had, completely disconnected from my life. I slept, had dreams, woke up, wasn’t sure where I was. I remember getting a cheese sandwich. The night was crazy, this miasma of things. I didn’t feel like I was back in my body until the next day.”

Doctors emphasize that while TGA is not a symptom or risk factor for stroke or other neurological disorder, people with some form of memory loss should be evaluated in a hospital.

Sicotte describes TGA as an existential as much as a physiological phenomenon. The hippocampi, humming like tiny tape recorders deep in the two temporal lobes of our brains without our conscious will, provide the data that lets us know who we are and where we are moment by moment.

On an episode of TGA, “the machinery our brains use to make new memories and also access old memories is offline,” Sicotte explains. “It’s like a switch went off. Maybe it’s a protective mechanism.”

TGA has been a source of fascination for neurologists, a syndrome that reminds medical interns and laymen alike how much we still have to learn about the way memories are formed, encoded, disappear and return.

While the experience is distressing for many patients, the after-effects are positive for some.

Lola sees her TGA as a time when her brain and body hit the pause button during a time of overwhelming stress. In addition to managing her usual deluge of work — a staff of 20 and constant decisions — she planned a trip to Peru.

The incident gave her a sense of deep relaxation and blissful well-being, she says. “My whole day consists of answering questions, dealing with problems, dealing with emergencies. At some point, the brain needs space. I see the incident as a re-evaluation.”

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