Transient global amnesia is characterized by a sudden memory loss of recent and/or remote events and transient inability to acquire new knowledge. Although mostly followed by complete recovery within a day, this rare and unexpected event in recovery phase after general anesthesia should be embarrassing and confusing, so we must proceed with prompt differential diagnosis for other organic intracranial pathology including transient ischemic attack and go on close observation. We describe a case of transient global amnesia of a 66-year-old woman after general anesthesia for excision and biopsy of left neck mass.
Aged ; Amnesia ; Amnesia, Transient Global ; Anesthesia, General ; Biopsy ; Diagnosis, Differential ; Female ; Humans ; Ischemic Attack, Transient ; Memory Disorders ; Neck

PURPOSE: Transient global amnesia (TGA) is characterized by abrupt onset of antegrade amnesia usually seeking emergency care. We analyzed the clinical characteristics of TGA patients and the significance of diffusion weighted imaging (DWI) in the diagnosis of TGA. METHODS: Retrospective analysis was performed using electronic medical records of patients diagnosed as TGA in the emergency departments from January 2003 to December 2013. The patient's clinical characteristics and precipitants were analyzed, and detection rate of hippocampal lesion was compared according to the time to DWI after symptom onset (<6 h, 6~12 h, 12~24 h, and >24 h). RESULTS: Of 372 consecutive TGA patients studied, 27 had a positive DWI lesion in hippocampus. Demographics and vascular risk profile were not significantly different between those in DWI (+) and DWI (-), and neither was duration of amnesia (p=0.076). However, the median time interval to DWI was significantly longer in DWI (+) than DWI (-) [7.5 (5.5~15.0) h vs. 6.0 (3.5~9.0) h, p=0.011]. In addition, the detection rate of hippocampal lesion increased with the time interval [0-6 h (4.1%), 6~12 h (10.7%), 12~24 h (11.1%), and >24 h (16.1%), p=0.004]. CONCLUSION: Positive hippocampal lesion on DWI can confirm the diagnosis of TGA; however, difference in lesion detectability in regard to time interval from symptom onset to DWI should be considered in diagnosis of TGA with DWI.
Amnesia ; Amnesia, Transient Global* ; Demography ; Diagnosis ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Electronic Health Records ; Emergency Medical Services ; Emergency Service, Hospital* ; Hippocampus ; Humans ; Retrospective Studies

BACKGROUND: Alcohol dependence and Alzheimer's disease induce cognitive dysfunction in common. However, the cognitive dysfunction from alcohol dementia can be improved with appropriate treatment while that from Alzhimer's disease is usually irreversible and progressive. Nevertheless, the discrete diagnosis for the cause is delicate or sometimes impossible in those patients showing both characteristics of alcohol dementia and Alzhimer's disease. Thus, we investigated the feasibility of the computerized comprehensive neuropsychological test, Cognitive Assessment and Reference Diagnoses System(CARDS), to differentiate the diagnoses between alcohol dementia and Alzhiemr's disease in their early stages. METHODS:32 elderly subjects with cognitive dysfunction were recruited. They are divided by two groups; 16 subjects with alcohol dependence and 16 subjects without alcohol dependence(as early Alzhiemr's disease) We assessed the cognitive dysfunctions of each group using CARDS. The subscales of the CARDS include; (1) Amnesia, (2) Aphasia, (3) Apraxia, (4) Dysexecution, (5) Attention/Calculation. RESULTS: Alcohol dependence group showed lower mean score in amnesia subscale, but showed higher mean scores in apraxia and dysexcution subscales than early Alzheimer group. And both groups didn't show significant differences of mean scores in agonisa, aphagia, and attention/calculation subscale. CONCLUSION: In summary, this study shows that the elderly patients with alcohol dependence have cognitive deficits mainly in the amnesia domain of CARDS assessment, whereas early Alzhiemr's disease patients show equal or worse cognitive function in other domains except amnesia. Thus, we suggest that CARDS will be helpful to differentiate alcoholic dementia and Alzhiemr's disease in their early stages.
Aged* ; Alcoholics ; Alcoholism* ; Alzheimer Disease* ; Amnesia ; Aphasia ; Apraxias ; Dementia ; Diagnosis* ; Humans ; Neuropsychological Tests

Insulinomas are very rare tumors. Diagnosis of insulinoma is often delayed or misdiagnosed because of its various symptoms. We report a patient with hypoglycemic encephalopathy who had repetitive behavior changes, diagnosed as a pancreatic insulinoma. A 52 years old man was referred to a memory and dementia clinic for evaluation of his repetitive abnormal behavior changes. He has threatened his wife with violent acts and showed aggressive behaviors, but he couldn't remember when he was recovered to normal state. During the hospitalization, we noticed that his repetitive abnormal behaviors were correlated to severe hypoglycemia. After we corrected glucose level, his symptoms were disappeared. We performed an abdomen-pelvis CT scan, revealing pancreatic head tumor. After he took surgical treatment, His symptoms were fully recovered. Our case demonstrates that various neurological symptoms, such as abnormal behavior, rarely occur due to recurrent hypoglycemia in patient with insulinoma.
Amnesia* ; Dementia ; Diagnosis ; Glucose ; Head ; Hospitalization ; Humans ; Hypoglycemia ; Insulinoma* ; Memory ; Spouses ; Tomography, X-Ray Computed

It has been claimed that the progress of psychiatry has lagged behind that of other medical disciplines over the last few decades. This may suggest the need for innovative thinking and research in psychiatry, which should consider neglected areas as topics of interest in light of the potential progress which might be made in this regard. This review is concerned with one such field of psychiatry: dissociation and dissociative disorders. Dissociation is the ultimate form of human response to chronic developmental stress, because patients with dissociative disorders report the highest frequency of childhood abuse and/or neglect among all psychiatric disorders. The cardinal feature of dissociation is a disruption in one or more mental functions. Dissociative amnesia, depersonalization, derealization, identity confusion, and identity alterations are core phenomena of dissociative psychopathology which constitute a single dimension characterized by a spectrum of severity. While dissociative identity disorder (DID) is the most pervasive condition of all dissociative disorders, partial representations of this spectrum may be diagnosed as dissociative amnesia (with or without fugue), depersonalization disorder, and other specified dissociative disorders such as subthreshold DID, dissociative trance disorder, acute dissociative disorders, and identity disturbances due to exposure to oppression. In addition to constituting disorders in their own right, dissociation may accompany almost every psychiatric disorder and operate as a confounding factor in general psychiatry, including neurobiological and psycho-pharmacological research. While an anti- dissociative drug does not yet exist, appropriate psychotherapy leads to considerable improvement for many patients with dissociative disorders.
Amnesia ; Depersonalization ; Diagnosis ; Dissociative Disorders ; Humans ; Multiple Personality Disorder ; Neurobiology ; Psychopathology ; Psychotherapy ; Thinking

Though congitive functions of a man decline in normal aging and memory decline is the most common complaint of an elderly, the status of quantitive and qualitative estimates of these are rare in Korea. To assess the qualitative and quantitive aspect of changes of memory in aging, neuropsychological tests about memory functions were performed and the results were.analyzed in healthy adult volunteers of 20 to 9 year-old, having no evidence-of organic brain dysfunction. The scores of each tests.are lower than that of English-speaking countries, but memory functions declined significantly in normal aging and the qualitative aspect of these are characteristics. Contrary to the western reports. The visuospatial memory declined significantly before the age of 50 and the verbal memory after 50 in aging. So we should take care in screening and diagnosis of dementia and amnesia using these neuropsychological test in Korea.
Adult* ; Aged ; Aging* ; Amnesia ; Brain ; Child ; Dementia ; Diagnosis ; Humans ; Korea ; Mass Screening ; Memory* ; Neuropsychological Tests ; Volunteers

OBJECTIVES: There is little research on the practice and effectiveness of electroconvulsive therapy (ECT) in Korea. This study investigated the practice pattern, effectiveness, and safety of ECT. METHODS: This chart review study included electronic medical records of 180 patients treated with ECT between January 2007 and December 2013 at the Asan Medical Center. Symptomatic improvement was assessed using Clinical Global Impression (CGI) scale. Treatment response was defined as CGI improvement scale score of 2 or less. Re-hospitalization was used as an indicator of recurrence. Safety was assessed by spontaneous reports from patients. RESULTS: One hundred and eighty patients underwent 1539 sessions of modified ECT. Their most frequent diagnosis was major depressive disorder (n=74, 41.1%). The most common indication for ECT was poor response to medication (n=177, 75.3%). Treatment response rate was 66.9% in acute phase group and 63.8% in the patients with poor response to medication. The recurrence rate at six months after the end of the course was 29.6%. Memory impairment or amnesia was the most common adverse effect. CONCLUSION: There was a remarkable improvement following ECT in patients who responded poorly to medications, and most adverse effects were tolerable and temporary. The present study suggests that ECT could be a useful treatment option.
Amnesia ; Chungcheongnam-do ; Depressive Disorder, Major ; Diagnosis ; Electroconvulsive Therapy* ; Electronic Health Records ; Humans ; Korea ; Memory ; Recurrence

Limbic encephalitis (LE) is characterized by short-term memory loss, disorientation, agitation, seizures, and histopathological evidence of medial temporal lobe inflammation. Leucine-rich, glioma inactivated 1 (LGI-1) is an auto-antigen associated with LE. We report a 37-year-old male patient with LGI-1-related LE who presented with recurrent episodes of selective amnesia, seizure-like activity, confusion, and personality change. His symptoms were significantly improved with steroid therapy. Thorough differential diagnosis with consideration for autoimmune encephalitis should be in patients with presentation of symptoms, such as memory impairment, personality change and seizure-like activity, especially when other neurological diagnoses are excluded.
Adult ; Amnesia ; Diagnosis ; Diagnosis, Differential ; Dihydroergotamine ; Encephalitis ; Glioma ; Humans ; Inflammation ; Limbic Encephalitis ; Male ; Memory ; Memory, Short-Term ; Seizures ; Temporal Lobe

We present here a case in which functional MR imaging (fMRI) was done for a patient who developed retrograde psychogenic amnesia for a four year period of her life history after a severe stressful event. We performed the fMRI study for a face recognition task using stimulation with three kinds of face photographs: recognizable familiar faces, unrecognizable friends' faces due to the psychogenic amnesia, and unfamiliar control faces. Different activation patterns between the recognizable faces and unrecognizable faces were found in the limbic area, and especially in the amygdala and hippocampus.
*Stress Disorders, Post-Traumatic ; *Magnetic Resonance Imaging ; Humans ; Hippocampus/physiology ; Female ; Amygdala/physiology ; Amnesia, Retrograde/*diagnosis/*etiology ; Adult

Toxocariasis is an important cause of secondary hypereosinophilia in Korea. Here, we describe a rare case of toxocariasis presenting as transient global amnesia due to secondary hypereosinophilia. A 44-year-old male visited the Emergency Department (ED) for transient global amnesia. He ate raw cow liver and omasum 2 weeks before the ED visit. The initial peripheral blood eosinophil count was 15,250/µL and serologic test for serum specific IgG antibodies to Toxocara canis larval antigen was positive. Radiologic studies revealed multiple small embolic infarctions of brainwithout cardioembolic sources or vascular abnormalities. He was treated with systemic corticosteroid, and neither neurologic deficit nor motor deficit was left. In our current case, the patient have a history of frequently eating raw cow liver and omasum, and his total IgE level was extremely high (>5,000 IU/mL). Thus, the patient was diagnosed as having toxocariasis and secondary hypereosinophilia. Toxocariasis should be considered in the differential diagnosis in patients with eosinophilia and atypical neurologic symptoms, such as transient amnesia.
Adult ; Amnesia ; Amnesia, Transient Global* ; Antibodies ; Cerebral Infarction ; Diagnosis, Differential ; Eating ; Emergency Service, Hospital ; Eosinophilia ; Eosinophils ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Infarction ; Korea ; Liver ; Male ; Neurologic Manifestations ; Omasum ; Serologic Tests ; Toxocara canis ; Toxocariasis*