Memory loss resident survival guide: Difference between revisions
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{{CMG}}; {{AE}}[[User:MoisesRomo|Moises Romo, M.D.]] | {{CMG}}; {{AE}}[[User:MoisesRomo|Moises Romo, M.D.]] | ||
{{SK}} | {{SK}} a''pproach to amnesia, approach to dementia, amnesia workup, dementia workup, approach to pseudodementia, pseudodementia workup'' | ||
==Overview== | ==Overview== | ||
[[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 stress disorder|post-traumatic]] [[amnesia]] is an example of this. [[Amnesia]] may also be spontaneous, in the case of [[transient global amnesia]]. This [[Global amnesia|global type of amnesia]] is more common in [[Middle age|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. | [[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 stress disorder|post-traumatic]] [[amnesia]] is an example of this. [[Amnesia]] may also be spontaneous, in the case of [[transient global amnesia]]. This [[Global amnesia|global type of amnesia]] is more common in [[Middle age|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. | ||
==Causes== | ==Causes== | ||
===Life Threatening Causes=== | ===Life Threatening Causes=== | ||
* | *[[Dead body|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: | ||
**[[Electrolyte imbalance|Electrolyte imbalances]] | **[[Electrolyte imbalance|Electrolyte imbalances]] | ||
**[[Head trauma]] | **[[Head trauma]] | ||
| Line 38: | Line 36: | ||
*[[Vitamin deficiency]] | *[[Vitamin deficiency]] | ||
*[[Depression]] | *[[Depression]] | ||
==Diagnosis== | ==Diagnosis== | ||
| Line 86: | Line 82: | ||
| B03= [[Frontotemporal dementia]] | | B03= [[Frontotemporal dementia]] | ||
| B04= [[Dementia with Lewy bodies]] | | B04= [[Dementia with Lewy bodies]] | ||
| B05= [[Parkinson disease | | B05= [[Parkinson's disease]]| }} | ||
{{familytree/end}}<br /> | {{familytree/end}}<br /> | ||
==Do's== | ==Do's== | ||
*Perform [[Laboratory|laboratory testing]] | *Perform [[Laboratory|laboratory testing]] to exclude potentially reversible causes of [[amnesia]]. Initial tests should include a [[CBC]], [[Toxicology screen|urine toxicology]], [[Thyroid function tests|thyroid function]], [[Folate deficiency|folate]], and [[vitamin B12]] level. | ||
*When a history of [[head trauma]] exists, perform an immediate [[CT scan|non-contrasted CT scan]] of the head to rule out intracerebral hemorrage. [[Neuroimaging]] may diagnose [[vascular disease]], [[normal pressure hydrocephalus]], [[tumors]], [[abscess]].<ref name="pmid11342678">{{cite journal |vauthors=Knopman DS, DeKosky ST, Cummings JL, Chui H, Corey-Bloom J, Relkin N, Small GW, Miller B, Stevens JC |title=Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology |journal=Neurology |volume=56 |issue=9 |pages=1143–53 |date=May 2001 |pmid=11342678 |doi=10.1212/wnl.56.9.1143 |url=}}</ref> | *When a history of [[head trauma]] exists, perform an immediate [[CT scan|non-contrasted CT scan]] of the head to rule out intracerebral hemorrage. [[Neuroimaging]] may diagnose [[vascular disease]], [[normal pressure hydrocephalus]], [[tumors]], [[abscess]].<ref name="pmid11342678">{{cite journal |vauthors=Knopman DS, DeKosky ST, Cummings JL, Chui H, Corey-Bloom J, Relkin N, Small GW, Miller B, Stevens JC |title=Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology |journal=Neurology |volume=56 |issue=9 |pages=1143–53 |date=May 2001 |pmid=11342678 |doi=10.1212/wnl.56.9.1143 |url=}}</ref> | ||
*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]].<ref name="pmid11342677">{{cite journal |vauthors=Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST |title=Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology |journal=Neurology |volume=56 |issue=9 |pages=1133–42 |date=May 2001 |pmid=11342677 |doi=10.1212/wnl.56.9.1133 |url=}}</ref> | *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]].<ref name="pmid11342677">{{cite journal |vauthors=Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST |title=Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology |journal=Neurology |volume=56 |issue=9 |pages=1133–42 |date=May 2001 |pmid=11342677 |doi=10.1212/wnl.56.9.1133 |url=}}</ref> | ||
*Always have in mind [[depression]] as a possible | *Always have in mind [[depression]] as a possible cause of [[Amnesia|memory impairmant]]. [[Depression]] is common cause of [[amnesia]]; a SIGE CAPS evaluation may disclose an underlying [[mood disorder]].<ref name="pmid32356472">{{cite journal |vauthors=Squire LR, Zouzounis JA |title=Self-ratings of memory dysfunction: different findings in depression and amnesia |journal=J Clin Exp Neuropsychol |volume=10 |issue=6 |pages=727–38 |date=December 1988 |pmid=3235647 |doi=10.1080/01688638808402810 |url=}}</ref> | ||
==Don'ts== | ==Don'ts== | ||
*If [[alcoholism]] and [[thiamine deficiency]] is suspected, do not administer [[glucose]] before [[thiamine]]. Administration of [[glucose]] before [[thiamine]] may lead to [[Wernicke's encephalopathy|Wernicke encephalopathy]].<ref name="HackHoffman1998">{{cite journal|last1=Hack|first1=Jason B.|last2=Hoffman|first2=Robert S.|title=Thiamine Before Glucose to Prevent Wernicke Encephalopathy: Examining the Conventional Wisdom|journal=JAMA|volume=279|issue=8|year=1998|pages=583|issn=0098-7484|doi=10.1001/jama.279.8.583a}}</ref> | *If [[alcoholism]] and [[thiamine deficiency]] is suspected, do not administer [[glucose]] before [[thiamine]]. Administration of [[glucose]] before [[thiamine]] may lead to [[Wernicke's encephalopathy|Wernicke encephalopathy]].<ref name="HackHoffman1998">{{cite journal|last1=Hack|first1=Jason B.|last2=Hoffman|first2=Robert S.|title=Thiamine Before Glucose to Prevent Wernicke Encephalopathy: Examining the Conventional Wisdom|journal=JAMA|volume=279|issue=8|year=1998|pages=583|issn=0098-7484|doi=10.1001/jama.279.8.583a}}</ref> | ||
==References== | ==References== | ||
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[[Category:Primary care]] | [[Category:Primary care]] | ||
[[Category:Up-To-Date]] | |||
Latest revision as of 03:20, 12 January 2021
| Memory loss Resident Survival Guide Microchapters |
|---|
| Overview |
| Causes |
| Diagnosis |
| Do's |
| Don'ts |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo, M.D.
Synonyms and keywords: approach to amnesia, approach to dementia, amnesia workup, dementia workup, approach to pseudodementia, pseudodementia workup
Overview
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.
Causes
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:
Common Causes
Diagnosis
Shown below is an algorithm summarizing the diagnosis of amnesia according to the the American Academy of Neurology guidelines:[1]
Do's
- 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.[2]
- 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.[3]
- 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.[4]
Don'ts
- If alcoholism and thiamine deficiency is suspected, do not administer glucose before thiamine. Administration of glucose before thiamine may lead to Wernicke encephalopathy.[5]
References
- ↑ Jahn H (December 2013). "Memory loss in Alzheimer's disease". Dialogues Clin Neurosci. 15 (4): 445–54. PMC 3898682. PMID 24459411.
- ↑ Knopman DS, DeKosky ST, Cummings JL, Chui H, Corey-Bloom J, Relkin N, Small GW, Miller B, Stevens JC (May 2001). "Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology". Neurology. 56 (9): 1143–53. doi:10.1212/wnl.56.9.1143. PMID 11342678.
- ↑ Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST (May 2001). "Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology". Neurology. 56 (9): 1133–42. doi:10.1212/wnl.56.9.1133. PMID 11342677.
- ↑ Squire LR, Zouzounis JA (December 1988). "Self-ratings of memory dysfunction: different findings in depression and amnesia". J Clin Exp Neuropsychol. 10 (6): 727–38. doi:10.1080/01688638808402810. PMID 3235647.
- ↑ 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.