2/18/2023 0 Comments Transient amnesia![]() ![]() During induction, his arterial blood pressure decreased from 180/90 mm Hg to 110/70 mm Hg. Anesthesia was maintained with 1.2% of isoflurane and a 50:50 percent mixture of nitrous oxide and oxygen. General anesthesia was induced with 200 mg of propofol IV and a laryngeal mask airway (LMA) was inserted. After receiving 100 μg of fentanyl the patient was positioned on the MRI table. His preoperative medications included atorvastatin, hydrocodone, ibuprofen, and calcium. His electrocardiogram showed normal sinus rhythm with a ventricular rate of 70 bpm. The patient's medical history was significant for coronary artery disease, migraine headaches, and depression with hallucinations. Because of severe pain associated with neck extension, an initial attempt to perform the MRI was unsuccessful and was rescheduled under general anesthesia. Based on these findings magnetic resonance imaging (MRI) of the cervical spine was ordered. The neurologist diagnosed mild weakness of the left arm external rotators, and an electromyogram showed evidence of a left C 7 radiculopathy with active denervation. Main Characteristics of Transient Global Amnesia Case Reports Case 1Ī 67-yr-old man underwent evaluation for left shoulder pain and paresthesias along the left C 5-C 6 dermatome. We report two cases of TGA after general anesthesia. There are only 3 reports of TGA associated with general anesthesia in the literature ( 1,9,10). In a significant number of cases a stressful precipitating factor can be identified ( 5,7,8) and excessive exertion preceding onset is present in 33.4% of cases ( 2). The incidence of TGA for the population older than 50 yr of age in Rochester, Minnesota is 23.5 per 100,000 per year ( 2). ![]() TGA usually affects patients between 50 and 60 yr of age, with a slightly increased incidence in females ( 2,7). The overall incidence of TGA in Rochester, Minnesota is 5.2 per 100,000 residents per year ( 2). The reported annual incidence ranges from 3 to 32 per 100,000 persons ( 6). The symptoms typically last from 30 min to 24 h ( 5). ![]() The memory loss is often accompanied by repetitive questioning and temporal disorientation (“Where am I? Why am I here?”) while other neurologic functions, such as alertness, complex manual tasks, and other higher cognitive functions are preserved. The amnesia frequently involves recent and remote events, with the extent of memory loss varying from person to person ( 2–4). The hallmark of TGA is short-term inability to form new memories despite otherwise normal neurological function ( 1) ( Table 1). Transient global amnesia (TGA) is a clinically dramatic, but poorly understood, amnestic syndrome. ![]()
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