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==Overview==
The underlying [[etiology]] of memory loss must be differentiated on the basis of duration of [[memory]] loss, presence of [[anterograde amnesia]] or [[retrograde amnesia]], associated features, and [[cognitive impairment]].


==Amnesia Differential Diagnosis==
==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<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>
==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]].<ref name = Markowitsch>{{cite journal |author=Markowitsch HJ |title=Psychogenic amnesia |journal=Neuroimage |volume=20 Suppl 1 |issue= |pages=S132–8 |year=2003 |pmid=14597306 |doi=}}</ref><ref name = Serra>{{cite journal |author=Serra L, Fadda L, Buccione I, Caltagirone C, Carlesimo GA |title=Psychogenic and organic amnesia: a multidimensional assessment of clinical, neuroradiological, neuropsychological and psychopathological features |journal=Behav Neurol |volume=18 |issue=1 |pages=53–64 |year=2007 |pmid=17297220 |doi=}}</ref> 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.<ref name = Serra/>
===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 [[clinical depression|major depressive disorder]].
The causes of dissociative fugue are similar to those of [[Psychogenic amnesia|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 [[Psychogenic amnesia|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.<ref>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.</ref>
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="2"  style="background: #4479BA; color: #FFFFFF; text-align: center;|Diseases
| colspan="3" rowspan="1"  style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Differentiating Features'''
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Duration of Amnesia
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|Associated Features
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Cognitive Impairment
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Post-traumatic amnesia<ref name="pmid11475324">{{cite journal| author=Leclerc S, Lassonde M, Delaney JS, Lacroix VJ, Johnston KM| title=Recommendations for grading of concussion in athletes. | journal=Sports Med | year= 2001 | volume= 31 | issue= 8 | pages= 629-36 | pmid=11475324 | doi=10.2165/00007256-200131080-00007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11475324  }} </ref>
| style="background: #F5F5F5; padding: 5px;" |Varies
| style="background: #F5F5F5; padding: 5px;" |[[Head]] [[Trauma]]
| style="background: #F5F5F5; padding: 5px;" |Variable, depends on the extent of [[brain]] [[injury]]<ref name="pmid22865461">{{cite journal| author=Wortzel HS, Arciniegas DB| title=Treatment of post-traumatic cognitive impairments. | journal=Curr Treat Options Neurol | year= 2012 | volume= 14 | issue= 5 | pages= 493-508 | pmid=22865461 | doi=10.1007/s11940-012-0193-6 | pmc=3437653 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22865461  }} </ref>
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Dissociative Amnesia]]<ref name="pmid18086739">{{cite journal| author=Bourget D, Whitehurst L| title=Amnesia and crime. | journal=J Am Acad Psychiatry Law | year= 2007 | volume= 35 | issue= 4 | pages= 469-80 | pmid=18086739 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18086739  }} </ref><ref> American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders : DSM-5</ref>
| style="background: #F5F5F5; padding: 5px;" |Variable. Could last minutes, hours, or rarely even months or years
| style="background: #F5F5F5; padding: 5px;" |Usually follows an incident that caused a lot of  [[stress]] and [[trauma]]
| style="background: #F5F5F5; padding: 5px;" |No [[cognitive impairment]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Transient global amnesia]]<ref name="pmid19031042">{{cite journal| author=Profice P, Rizzello V, Pennestrì F, Pilato F, Della Marca G, Sestito A | display-authors=etal| title=Transient global amnesia during transoesophageal echocardiogram. | journal=Neurol Sci | year= 2008 | volume= 29 | issue= 6 | pages= 477-9 | pmid=19031042 | doi=10.1007/s10072-008-1034-y | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19031042  }} </ref>
| style="background: #F5F5F5; padding: 5px;" |Less than 24hrs
| style="background: #F5F5F5; padding: 5px;" |[[Brain]] [[ischemia]], [[migraine]], [[seizure]], [[venous congestion]], [[psychological trauma]].
| style="background: #F5F5F5; padding: 5px;" |No [[cognitive impairment]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Drug]]-Induced Amnesia<ref> Amnesia is anterograde from the time the drug was introduced and patient has impairment in forming new memories. It is reversible upon discontinuation of the [[drug]].</ref>
| style="background: #F5F5F5; padding: 5px;" |Once drug is stopped, memory gradually regained
| style="background: #F5F5F5; padding: 5px;" |[[Benzodiazepines]]
| style="background: #F5F5F5; padding: 5px;" |No [[cognitive impairment]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Neurological Amnesia
| style="background: #F5F5F5; padding: 5px;" |Does not resolve, [[patient]] experiences progressive [[memory]] loss.
| style="background: #F5F5F5; padding: 5px;" |[[Alzheimer's disease]], [[Pick's disease]], [[Parkinson's disease]]
| style="background: #F5F5F5; padding: 5px;" |Progressive [[cognitive impairment]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Transient epileptic amnesia<ref name="pmid9576532">{{cite journal| author=Zeman AZ, Boniface SJ, Hodges JR| title=Transient epileptic amnesia: a description of the clinical and neuropsychological features in 10 cases and a review of the literature. | journal=J Neurol Neurosurg Psychiatry | year= 1998 | volume= 64 | issue= 4 | pages= 435-43 | pmid=9576532 | doi=10.1136/jnnp.64.4.435 | pmc=2170058 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9576532  }} </ref>
| style="background: #F5F5F5; padding: 5px;" |Episodic transient amnesia
| style="background: #F5F5F5; padding: 5px;" |History of [[temporal lobe]] [[epilepsy]]
| style="background: #F5F5F5; padding: 5px;" |No [[cognitive impairment]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Age-Related Amnesia<ref name="pmid17222085">{{cite journal| author=Waldemar G, Dubois B, Emre M, Georges J, McKeith IG, Rossor M | display-authors=etal| title=Recommendations for the diagnosis and management of Alzheimer's disease and other disorders associated with dementia: EFNS guideline. | journal=Eur J Neurol | year= 2007 | volume= 14 | issue= 1 | pages= e1-26 | pmid=17222085 | doi=10.1111/j.1468-1331.2006.01605.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17222085  }} </ref>
| style="background: #F5F5F5; padding: 5px;" |Slow and progressive [[memory]] loss
| style="background: #F5F5F5; padding: 5px;" |Diagnosis of exclusion
| style="background: #F5F5F5; padding: 5px;" |No [[cognitive impairment]]
|}


==References==
==References==
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[[Category:Mature chapter]]
[[Category:Memory disorders]]
[[Category:Memory disorders]]
[[Category:Signs and symptoms]]
 
[[Category:Needs overview]]
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Latest revision as of 01:34, 25 March 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Overview

The underlying etiology of memory loss must be differentiated on the basis of duration of memory loss, presence of anterograde amnesia or retrograde amnesia, associated features, and cognitive impairment.

Amnesia Differential Diagnosis

Diseases Differentiating Features
Duration of Amnesia Associated Features Cognitive Impairment
Post-traumatic amnesia[1] Varies Head Trauma Variable, depends on the extent of brain injury[2]
Dissociative Amnesia[3][4] Variable. Could last minutes, hours, or rarely even months or years Usually follows an incident that caused a lot of stress and trauma No cognitive impairment
Transient global amnesia[5] Less than 24hrs Brain ischemia, migraine, seizure, venous congestion, psychological trauma. No cognitive impairment
Drug-Induced Amnesia[6] Once drug is stopped, memory gradually regained Benzodiazepines No cognitive impairment
Neurological Amnesia Does not resolve, patient experiences progressive memory loss. Alzheimer's disease, Pick's disease, Parkinson's disease Progressive cognitive impairment
Transient epileptic amnesia[7] Episodic transient amnesia History of temporal lobe epilepsy No cognitive impairment
Age-Related Amnesia[8] Slow and progressive memory loss Diagnosis of exclusion No cognitive impairment

References

  1. ↑ Leclerc S, Lassonde M, Delaney JS, Lacroix VJ, Johnston KM (2001). "Recommendations for grading of concussion in athletes". Sports Med. 31 (8): 629–36. doi:10.2165/00007256-200131080-00007. PMID 11475324.
  2. ↑ Wortzel HS, Arciniegas DB (2012). "Treatment of post-traumatic cognitive impairments". Curr Treat Options Neurol. 14 (5): 493–508. doi:10.1007/s11940-012-0193-6. PMC 3437653. PMID 22865461.
  3. ↑ Bourget D, Whitehurst L (2007). "Amnesia and crime". J Am Acad Psychiatry Law. 35 (4): 469–80. PMID 18086739.
  4. ↑ American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders : DSM-5
  5. ↑ Profice P, Rizzello V, Pennestrì F, Pilato F, Della Marca G, Sestito A; et al. (2008). "Transient global amnesia during transoesophageal echocardiogram". Neurol Sci. 29 (6): 477–9. doi:10.1007/s10072-008-1034-y. PMID 19031042.
  6. ↑ Amnesia is anterograde from the time the drug was introduced and patient has impairment in forming new memories. It is reversible upon discontinuation of the drug.
  7. ↑ Zeman AZ, Boniface SJ, Hodges JR (1998). "Transient epileptic amnesia: a description of the clinical and neuropsychological features in 10 cases and a review of the literature". J Neurol Neurosurg Psychiatry. 64 (4): 435–43. doi:10.1136/jnnp.64.4.435. PMC 2170058. PMID 9576532.
  8. ↑ Waldemar G, Dubois B, Emre M, Georges J, McKeith IG, Rossor M; et al. (2007). "Recommendations for the diagnosis and management of Alzheimer's disease and other disorders associated with dementia: EFNS guideline". Eur J Neurol. 14 (1): e1–26. doi:10.1111/j.1468-1331.2006.01605.x. PMID 17222085.

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