Memory loss

Definition

Memory loss (amnesia) is unusual forgetfulness that can be caused by brain damage due to disease or injury, or it can be caused by severe emotional trauma.

Considerations

The cause determines whether amnesia comes on slowly or suddenly, and whether it is temporary or permanent.

Normal aging may result in trouble learning new material or requiring longer time to recall learned material. However, it does not lead to dramatic memory loss unless diseases are involved.

Common Causes

• Aging
• Alzheimer's disease
• Neurodegenerative illness
• Head trauma or injury
• Hysteria often accompanied by confusion
• Seizures
• General anesthetics such as halothane, isoflurane, and fentanyl
• Alcoholism
• Stroke or transient ischemic attack (TIA)
• Transient global amnesia
• Drugs such as barbiturates or benzodiazepines
• Electroconvulsive therapy (especially if prolonged)
• Temporal lobe brain surgery
• Brain masses (caused by tumors or infection)
• Herpes encephalitis
• Other brain infections
• Depression

Home Care

Family support should be provided. Reality orientation is recommended -- supply familiar music, objects, or photos, to help the patient become oriented. Support for relearning may be required in some cases.

Any medication schedules should be written down to avoid dependence on memory.

Extended care facilities, such as nursing homes, should be considered for people whose basic needs cannot be met in any other way, or whose safety or nutrition is in jeopardy.

Call your health care provider if

Call your health care provider if there is any unexplained memory loss.

What to expect at your health care provider's office

The doctor will perform a thorough examination and take a medical history. This may require asking questions of family members and friends.

Medical history questions documenting memory loss in detail may include the following:

• Type
  • Can the person remember recent events (is there impaired short-term memory)?
  • Can the person remember events from further in the past (is there impaired long-term memory)?
  • Is there a loss of memory about events that occurred prior to a specific experience (anterograde amnesia)?
  • Is there a loss of memory about events that occurred soon after a specific experience (retrograde amnesia)?
  • Is there only a minimal loss of memory?
  • Does the person make up stories to cover gaps in memory (confabulation)?
  • Is the person suffering from low moods that impair concentration?
• Time pattern
  • Has the memory loss been getting worse over years?
  • Has the memory loss been developing over weeks or months?
  • Is the memory loss present all the time or are there distinct episodes of amnesia?
  • If there are amnesia episodes, how long do they last?
• Aggravating or triggering factors
  • Has there been a head injury in the recent past?
  • Has the person experienced an event that was emotionally traumatic?
  • Has there been a surgery or procedure requiring a general anesthetic?
  • Does the person use alcohol? How much?
  • Does the person use illegal/illicit drugs? How much? What type?
• Other symptoms
  • What other symptoms are present?
  • Is the person confused or disoriented?
  • Can they independently eat, dress, and perform similar self-care activities?
  • Have they had seizures?

Physical examination may include a detailed neurological examination. Recent, intermediate, and long-term memory will be tested.

Diagnostic tests that may be performed include the following:

• Cerebral angiography
• CT scan or MRI of the head
• EEG
• Blood tests (for specific diseases that are suspected)
• Psychometric tests (cognitive tests)
• Lumbar puncture

Illustrations

Central nervous system

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