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On the Brain
June 1, 2020

Any Recent Stressors?—A Memoir of Transient Global Amnesia

Author Affiliations
  • 1University of Rochester School of Medicine & Dentistry, Rochester, New York
JAMA Neurol. 2020;77(10):1205-1206. doi:10.1001/jamaneurol.2020.1403

Memory… is the diary that we all carry about with us.

Oscar Wilde, The Importance of Being Earnest, 1895

A 51-year-old previously healthy man presented with sudden onset of amnesia that resolved in an hour. As part of the evaluation for suspected transient global amnesia (TGA), several physicians and nurses in the emergency department and in an inpatient unit independently asked about recent stressful life events. The patient always replied, “My father-in-law’s funeral was yesterday.” Each evaluator nodded in comprehension and moved on to the rest of the history and examination. Nobody asked an open-ended question exploring the patient’s loss, relationship with his father-in-law, or anything to encourage expansion of the topic.

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    2 Comments for this article
    Well taken! Will be more careful and caring
    Arvind Joshi, MBBS MD FCGP FAMS FICP | Our Own Discussion Group, Mumbai, India; Ruchi Diagnostic Center /Ruchi Clinical Laboratory, Kharghar, India
    I always thought of myself as empathetic to those who seek my care. This article made me self-reflect. Have my previous patient interactions live up to Dr. Lyness' expectations? Though I hope that these previous interactions would have stood up to his scrutiny,  they still nudge me to be more empathetic, more concerned about what the person under my care may need from me, and more insightful of the inner and deeper workings of the mind of the person under my care. Thank You Dr. Lyness, you did drive home your point!
    Arvind Joshi, MBBS MD FCGP FAMS
    TGA Research Study
    Jo-Ann Vass | Bassett Medical Center
    In a prior issue of JAMA, I read on a TGA Research study,  published in July 1986:The Prognosis of Transient Global Amnesia. Results of a Multicenter Study (Danish study). This current article had interesting theories of TGA (my sister had an attack while shopping, guess that could be stress related). At any rate, the good news is they indicate the risk of recurrence of TGA is very low at 4.7%.
    I was an ED nurse for 36 years and saw several cases, but never the same person twice. I wish I had known to ask more questions on a personal
    level. TGA seems to remain somewhat of a mystery but personal experience can be a great learning point for us all; I know your colleagues are aware of that.
    I always say TGA is more stressful for loved ones than the patient largely due to the incessant repetitive questions from the patient! Thank you