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PubMedDate not supplied

Anterograde amnesia as a possible postoperative complication of Midazolam as an agent for intravenous conscious sedation.

Anterograde amnesia is often considered to be a beneficial effect of intravenous conscious sedation. The recently introduced benzodiazepine, midazolam, has associated with its administration a significant anterograde amnesic period. In the case presented here, a healthy young female presented for third molar extraction under midazolam conscious sedation and local anesthesia. After uncomplicated removal of the teeth and clinically adequate recovery from sedation, it was noted that the patient had swallowed the postsurgical gauze packs. Efforts at recovery of the gauze packs were futile. Follow-up discussion with the patient revealed a complete lack of recall of all events occurring for up to an hour or more after the administration of intravenous midazolam. The need for written and oral postoperative instructions to both the patient and his/her escort is emphasized.

Adult↗
PubMed1988

Epileptic transient amnesia.

Transient global amnesia (TGA) was formerly supposed to have an epileptic origin thought unlikely by more recent authors. Further, epileptic seizures rarely present transient memory dysfunction as prominent symptom. These particular cases of which we report here three examples were previously identified as epileptic amnesic attacks (EAA). They have uniform clinical characteristics quite different from TGA and respond favorably to antiepileptic therapy. The features differentiating these two conditions are discussed. The authors suggest that an epileptic origin should be considered in patients presenting frequent transient amnesic attacks.

Aged↗
PubMed1988

Transient global amnesia after mild head injury in childhood.

In seven entirely healthy children in the age group of 6.5 to 14.5 years, mild head injury produced transient global amnesia (TGA) of median duration of 4.5 hours. None of the patients had convincing signs of brain concussion or clinical focal symptomatology. In four cases CT examination of the brain showed normal findings. Four children had a transient abnormal EEG (intermittent delta rhythms, slowed background activity inconstant local finding (of slow waves). During the period monitored (2-34 months) there was no recurrent attack and the children have had no difficulties. Pathologically, the authors assume ischemia of temporobasal structures induced by mild trauma with a relationship to migraine diathesis and rank the child group among so called benign posttraumatic encephalopathy with a noncomplicated course and good outcome.

Adolescent↗
PubMed1987

[Transient global amnesia syndrome].

Nine patients with the syndrome of transitory global amnesia (TGA) have been examined. The authors present the clinical characteristics of the syndrome, describe the differential diagnosis, forms and course of the syndrome, as well as methods of its treatment and prognosis. It has been demonstrated that the syndrome of TGA may develop in the presence of both primary cerebral pathology (insufficient circulation in the vertebrobasilar system) and general pathogenic impacts leading to impairment of the systemic and cerebral hemodynamics. It has been established that transient recurrent mnemonic disturbances during the follow-up are associated with the formation of a stable Korsakoff's syndrome. Methods of therapy of these disorders have been developed and the diagnostic and prognostic significance of neuropsychological examination has been demonstrated.

Adult↗
PubMedDate not supplied

[Post-traumatic amnesia in the evaluation of minor cranial injuries].

Quantitative assessment of brain damage is a primary condition for studies in neurotraumatology. Scored clinical evaluation, neurophysiological and neuroimaging techniques are usefully applied in highly disabled or comatose patients. In minor head injury (MHI), where focal neurological signs are excluded by definition, quantification of brain dysfunction is still uncertain. We compared the incidence of post-traumatic amnesia (PTA), skull fractures and altered Auditory Brainstem Responses (ABR) in 165 patients examined within 48 hours from a MHI. Skull fractures were found in 25%. They are, however, an indirect evidence of potential cerebral damage. ABR alterations, which show brainstem dysfunction, were present in 10% only. PTA exceeding 30 min occurred in 60% of MHI patients. This clinical method seems a sensitive method for assessing brain dysfunction even in MHI patients.

Adolescent↗
PubMed1987

Amnesia following right thalamic haemorrhage.

A 52 year old patient with a right thalamic haemorrhage is described. She suffered from anterograde amnesia and memory impairment for both visual and verbal material. At follow-up after 3 months, despite being fully oriented and having good concentration, her memory impairment was still evident. Reassessment 3 years afterwards showed persistent deficits and no further improvement.

Amnesia↗
PubMed1986

[Bilateral thalamic infarcts with abnormal movements and permanent amnesia].

A 45 year-old woman with mitral valve disease developed bilateral thalamic infarcts presenting as vigilance disorders, with mutism and downwards gaze paralysis during several days, followed by involuntary rhythmic movements over 13 days. These movements affected the four limbs with a rhythm variable with time as alternate or synchronized agonist-antagonist periods. Subsequent examinations demonstrated global, lasting amnesia and a subclinical disorder of vertical ocular movements. Repeat CT scan confirmed the presence of bilateral anterior thalamic infarcts affecting polar and/or paramedian territories. Emphasis is placed on the similarity of the abnormal movements in this case with L-dopa induced involuntary movements.

Amnesia↗
PubMed1986

[Paralysis of downward gaze and chronic global amnesia as a result of a bilateral thalamo-subthalamic lesion].

A 47 year-old male was found in coma and upon awakening 36 hours later, he showed a selective paralysis of downward gaze and convergence associated to an intellectual impairment. He was euphoric, unconcerned, poorly attentive, and had a severe amnesia for both anterograde and retrograde material. CT scan and NMR demonstrated a bilateral lacunar lesion of thalamic and subthalamic paramedian region. Over the 5 years follow-up, behavioral, personality and amnestic changes remained. On the other hand, supranuclear gaze paralysis improved as documented by EOG recordings with persisting limitations in voluntary down movements amplitude and dramatic reduction of fast components velocity.

Amnesia↗
PubMedDate not supplied

[Transitory global amnesia].

The authors studied 18 cases of transient global amnesia, a syndrome occurring in middle age, characterized by a sudden memory loss of recent events and transient inability to acquire new knowledge, while consciousness and personal identity are preserved. Chemical and laboratory findings indicates that TGA is probably due to transient ischemia in the temporal lobe and hippocampus.

Aged↗
PubMed1985

Closed head injury in spinal cord injured patients: retrospective study of loss of consciousness and post-traumatic amnesia.

Previous studies of trauma-related spinal cord injured patients suggest that 25% to 50% of these patients sustain a concomitant cranio-cerebral trauma. A loss of consciousness (LOC) of 20 minutes' duration or a post-traumatic amnesia (PTA) lasting 24 hours has been associated with deficits in concentration, attention, memory, and higher-level cognitive functions. These may present as significant factors influencing learning and adaptation during and after the formal rehabilitation process. A systematic review was performed of the medical records of 101 trauma-related spinal cord injured patients who were admitted to Northwestern Memorial Hospital and the Rehabilitation Institute of Chicago within seven days of injury. The reported incidence of LOC and PTA in spinal cord injured patients was evaluated, and these data were compared with the level and etiology of injury, and with radiographic work-up, if any, for head injury. Eighty-seven percent of all emergency room admissions and 67% of all rehabilitation admissions were assessed for LOC. Fewer than 25% of all patients in both settings were assessed for PTA. Forty-two percent of all patients reported LOC, PTA, or both occurring simultaneously with the spinal cord injury. Assessment and incidence were unrelated to level of injury but were influenced by etiology. One-third of the patients who reported LOC, PTA, or both underwent further evaluation with computed tomographic (CT) scan or radiography of the skull. Assessment of LOC is conducted more consistently in the ER than in the rehabilitation setting. Assessment of PTA is performed infrequently despite its relevance to the rehabilitation process. Head injury may frequently be associated with traumatic spinal cord injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗