Amnesia differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]

Amnesia Differential Diagnosis

  • Catatonic stupor
  • Dissociative identity disorder
  • Neurocognitive disorders
  • Normal and age-related changes in memory
  • Postraumatic amnesia due to brain injury
  • Postraumatic stress disorder
  • Seizure disorders
  • Substance-related disorders
  • Factitious disorder and malingering[1]

Differentiating Amnesia from other Diseases

Differentiating Psychogenic Amnesia from Organic Amnesia

Clinically, psychogenic amnesia is characterized by the loss of the ability to retrieve stored memory without having damages to the brain while organic amnesia is characterized by damages to the medial or anterior temporal and/or prefrontal regions caused by stroke, traumatic brain injury, ischemia, and encephalitis.[2][3] Some characteristics that define organic amnesia is the maintenance of personal identity, basic semantic knowledge and procedural skills as well as neuroradiological images showing cerebral damage to the cortical and/or subcortical areas known to be associated with long-term memory while some characteristics that define psychogenic amnesia is the loss of personal identity, semantic knowledge, and procedural abilities at least in the early phase of amnesia as well as damage directly affecting cerebral areas critical for memory functioning that cannot be detected in clinical history or neuroradiological exams.[3]

Differentiating Disociative Fugue from other Diseases

Some disorders have similar symptoms. The clinician, therefore, in his or her diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis: dementia, head trauma, substance intoxication, early symptoms of neurological disorders (example- multiple sclerosis) may resemble conversion symptoms. Similarly, other psychological disorders may manifest symptoms similar to dissocative fugues. These include bipolar disorder, schizophrenia and major depressive disorder.

The causes of dissociative fugue are similar to those of dissociative amnesia and dissociative identity disorder. Dissociative fugue is often mistaken for malingering, because both conditions may occur under circumstances that a person might understandably wish to evade. However, Dissociative Fugue occurs spontaneously and is not faked. Malingering is a state in which a person feigns illness because it removes them from accountability for their actions, gives them an excuse to avoid responsibilities, or reduces their exposure to a known hazard, such as a dangerous job assignment. Many fugues seem to represent a disguised wish fulfillment (for example, an escape from overwhelming stresses, such as divorce or financial ruin). Other fugues are related to feelings of rejection or separation, or they may protect the person from suicidal or homicidal impulses. Similar to dissociative amnesia, the dissociative fugue usually affects personal memories from the past, rather than encyclopedic or abstract knowledge. A dissociative fugue therefore does not imply any overt seeming or "crazy" behavior.

Differentiating Transient Global Amnesia from other Diseases

Transient global amnesia is differentiated from stroke by the lack of tingling, peripheral limb involvement, speech impairment or ability to walk. It is differentiated from subarachnoid hemorrhage from the lack of headache.[4]

References

  1. Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.
  2. Markowitsch HJ (2003). "Psychogenic amnesia". Neuroimage. 20 Suppl 1: S132–8. PMID 14597306.
  3. 3.0 3.1 Serra L, Fadda L, Buccione I, Caltagirone C, Carlesimo GA (2007). "Psychogenic and organic amnesia: a multidimensional assessment of clinical, neuroradiological, neuropsychological and psychopathological features". Behav Neurol. 18 (1): 53–64. PMID 17297220.
  4. Monzani V, Rovellini A , Schinco G , et al. Transient global amnesia or subarachnoid haemorrhage? Clinical and laboratory findings in a particular type of acute global amnesia. Eur J Emerg Med 2000;7:291–3.



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