Memory loss resident survival guide
|Memory loss Resident Survival Guide Microchapters|
Synonyms and Keywords: Approach to amnesia, Approach to dementia, Amnesia workup, Dementia workup, Approach to pseudodementia, Pseudodementia workup
Amnesia is a condition in which memory is disturbed or lost. The causes of amnesia can be organic or functional. Organic causes include damage to the brain through trauma or disease or the use of certain (generally sedative) drugs. Functional causes are psychological factors, such as defense mechanisms. Hysterical post-traumatic amnesia is an example of this. Amnesia may also be spontaneous, in the case of transient global amnesia. This global type of amnesia is more common in middle-aged to elderly people, particularly males, and usually lasts less than 24 hours. Memory loss can be partial or total and is normally expected as we get older.
Life Threatening Causes
- Death or permanent disability may occur within 24 hours if left untreated. Most acute causes of amnesia are considered life-threatening, among them, are the following:
- Perform laboratory testing to exclude potentially reversible causes of amnesia. Initial tests should include a CBC, urine toxicology, thyroid function, folate, and vitamin B12 level.
- When a history of head trauma exists, perform an immediate non-contrasted CT scan of the head to rule out intracerebral hemorrage. Neuroimaging may diagnose vascular disease, normal pressure hydrocephalus, tumors, abscess.
- Perform a minimental status test on physical examination and pay especial attention in concentration domain. Minimental testing has the potential distinguish mild cognitive impairment from dementia.
- Always have in mind depression as a possible cause of memory impairmant. Depression is common cause of amnesia; a SIGE CAPS evaluation may disclose an underlying mood disorder.
- If alcoholism and thiamine deficiency is suspected, do not administer glucose before thiamine. Administration of glucose before thiamine may lead to Wernicke encephalopathy.
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- Hack, Jason B.; Hoffman, Robert S. (1998). "Thiamine Before Glucose to Prevent Wernicke Encephalopathy: Examining the Conventional Wisdom". JAMA. 279 (8): 583. doi:10.1001/jama.279.8.583a. ISSN 0098-7484.