Abstract Details

Title Case Report and Novel Theory for Transient Global Amnesia

Topic General Neurology

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 2-004

Objective to propose a new theory on the causation of TGA.

Background

A healthy 54 year old writer/lawyer developed typical symptoms of TGA while camping with her family. After sitting beneath a waterfall, she was cold and shivering. She kept repeating the same questions but had no focal neurologic deficits. She could not retain any new information. Approximately 6 hours later, she was back to normal.

TGA has been theorized to arise from CNS ischemia or focal seizure activity. However typical patients do not develop strokes and usually have no vascular risk factors. They also do not develop epilepsy.

A more logical explanation would be neurotransmitter changes causing TGA. Triggers for TGA include cold water, exercise, stress and sex. These factors are known to increase GABA and glutamate activity. Cold water increases glutamate activity in mice. Versed causes amnesia and enhances GABA receptor affinity. Topiramate can cause memory impairment and potentiates GABA transmission. Sex and vigorous exercise increase GABA and glutamate.

Design/Methods This theory is based on the case report and review of the literature.

Results A new theory to explain TGA.

Conclusions We postulate that neurotransmitter changes in GABA and/or glutamate provoke the transient symptoms of TGA. A GABA antagonist such as bilobalide, contained in Ginko Baloba, and/or a glutamate antagonist such as amantadine, might prove effective in reducing the duration of symptoms, duration of hospitalization, and need for extensive diagnostic testing, with little risk of morbidity.

Authors/Disclosures
William J. Kingston, MD PRESENTER	Dr. Kingston has nothing to disclose.
Anne M. Moss, MD	No disclosure on file

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