Amnesia natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]; Jesus Rosario Hernandez, M.D. [3]

Natural History

Amnesia may progress slowly or suddenly, and maybe transient or permanent. The natural history and prognosis depends upon the underlying cause.

Complications

The underlying cause of amnesia determines whether it presents slowly or suddenly, and whether it is temporary or permanent. A complication of amnesia is the inability to imagine the future. A recent study published online in the Proceedings of the National Academy of Sciences shows that amnesiacs with a damaged hippocampus cannot imagine the future. This is because when a normal human being imagines the future, they use their past experiences to construct a possible scenario. For example, a person who would try to imagine what would happen at a party in the near future would use their past experience at parties to help construct what the event might be like in the future.

Prognosis

Poor prognosis factors include:

  • Physical abuse
  • Sexual abuse
  • Stressful situations (e.g. war, natural disaster, genocide)
  • Flashbacks[1]

Dissociative Fugue

Most dissociative fugues last for hours or days or months, unresolved and may return. Dissociative fugue is treated much the same as dissociative amnesia and dissociative identity disorder, and treatment is therapy aimed at helping the person restore lost memories as soon as possible. Most people who suffer dissociative fugues regain most or all of their prior memories; however, efforts to restore memories of the fugue period usually are unsuccessful.

Transient Global Amnesia

The prognosis of TGA is very good. It does not affect mortality and has a small recurrence rate.

"The most important part of management after diagnosis is looking after the psychological needs of the patient and his or her relatives. Seeing a once competent and healthy partner, sibling or parent become incapable of remembering what was said only a minute ago is very distressing, and hence it is often the relatives who will require reassurance." [2]

References

  1. Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.
  2. Magnus Harrison and Mark Williams The diagnosis and management of transient global amnesia in the emergency department Emerg Med J 2007; 24: 444-445. doi:10.1136/emj.2007.046565




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