Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Do My Lab Test Reports Indicate?
Question: My sister-in-law recently had a memory-related problem. She was to meet me at the airport in O.C.,but she
missed her plane in XXXXXXX She also forgot one piece of luggage at the airport and had to have a friend retrieve it. A friend picked her up from airport and took her home and called her daughter because she
was not responding well.
Her daughter said her mom couldn't understand why she should call me and let me know she missed her flight. She was not aware or could not answer these questions: What and when did you eat last night?
Where is your purse and wallet? She didn't know how to get to the hospital she frequently goes to.
She didn't know how to shut the car door. She didn't remember her boat trip of 2 days ago,
She had trouble forming sentences.
Her daughter took her to Kaiser ER and they asked her what month it was, and she said February (when it was October). Kaiser admitted her for a CT Scan and MRI and did an EKG. They could find no signs of stroke so
they released her with no scheduled future appt. with a doctor. She is trying to get to see a doctor still.
After 24 hours, she was lucid, clear, and forming complete sentences and sounded like her normal self.
The family is very concerned about the cause of this amnesia, memory loss.
For over 10 years, she has almost daily misplaced car keys, house keys, sun glasses, regular glasses,
and cell phone (which she has lost several times and had to replace). She has had trouble paying bills and frequently stacks them up or hides them in a plastic bag. Her daughter will help her pay them when she realizes what has happened. She gets lost while driving, and when given a GPS was better, but then she
lost that. She is about 69 or 70 and her sister has advanced Alzheimer's and is in a residential facility.
She lives by herself and manages her properties, but not as adroitly as could be done, however, she does
arrange for repairs and handles banking. She drives but frequently gets hit by cars with minor damage to her vehicle.
This airport incident is a startling XXXXXXX Her symptoms are new. Although when asked, she believes she has had a seizure as she is also epileptic.
What is your diagnosis and advice?FYI: When my niece was asking her mom questions, she could remember her birthday, people's names, when Thanksgiving is this year.
Again, amnesia/memory loss happened around 10am - 1 pm on Tuesday, Nov. 11,
she was in ER around 4 pm, she went hone around 12:30 am--at midnight she
was still not able to formulate a sentence.
At 8 am on Wed., Nov. 12, she telephoned me and was speaking normally and coherently. She seemed to remember some things (but not sure if remembered
everything). She was XXXXXXX and active at daughter's house and talking on cell
to friends.
missed her plane in XXXXXXX She also forgot one piece of luggage at the airport and had to have a friend retrieve it. A friend picked her up from airport and took her home and called her daughter because she
was not responding well.
Her daughter said her mom couldn't understand why she should call me and let me know she missed her flight. She was not aware or could not answer these questions: What and when did you eat last night?
Where is your purse and wallet? She didn't know how to get to the hospital she frequently goes to.
She didn't know how to shut the car door. She didn't remember her boat trip of 2 days ago,
She had trouble forming sentences.
Her daughter took her to Kaiser ER and they asked her what month it was, and she said February (when it was October). Kaiser admitted her for a CT Scan and MRI and did an EKG. They could find no signs of stroke so
they released her with no scheduled future appt. with a doctor. She is trying to get to see a doctor still.
After 24 hours, she was lucid, clear, and forming complete sentences and sounded like her normal self.
The family is very concerned about the cause of this amnesia, memory loss.
For over 10 years, she has almost daily misplaced car keys, house keys, sun glasses, regular glasses,
and cell phone (which she has lost several times and had to replace). She has had trouble paying bills and frequently stacks them up or hides them in a plastic bag. Her daughter will help her pay them when she realizes what has happened. She gets lost while driving, and when given a GPS was better, but then she
lost that. She is about 69 or 70 and her sister has advanced Alzheimer's and is in a residential facility.
She lives by herself and manages her properties, but not as adroitly as could be done, however, she does
arrange for repairs and handles banking. She drives but frequently gets hit by cars with minor damage to her vehicle.
This airport incident is a startling XXXXXXX Her symptoms are new. Although when asked, she believes she has had a seizure as she is also epileptic.
What is your diagnosis and advice?FYI: When my niece was asking her mom questions, she could remember her birthday, people's names, when Thanksgiving is this year.
Again, amnesia/memory loss happened around 10am - 1 pm on Tuesday, Nov. 11,
she was in ER around 4 pm, she went hone around 12:30 am--at midnight she
was still not able to formulate a sentence.
At 8 am on Wed., Nov. 12, she telephoned me and was speaking normally and coherently. She seemed to remember some things (but not sure if remembered
everything). She was XXXXXXX and active at daughter's house and talking on cell
to friends.
Brief Answer:
Transient global amnesia most likely.
Detailed Answer:
I read your question carefully and I understand your concern about your sister in law.
Since an MRI has been performed I agree with the doctors that a stroke or other brain lesions are to be excluded, the MRI is the most sensitive test on that regard. In fact while the lack of an explanation might seem alarming to you you should feel reassured as threatening causes can be safely excluded given those normal tests.
The most likely possibility for what happened is transient global amnesia, a sudden episode of temporary memory loss not explained by a neurological condition. It is a recognized and common diagnosis the underlying cause of which is still unknown. It is more common in patients over 50 and there are some possible triggers among which may be emotional stress such as the potential stress before a journey in this case. It might happen in the absence of any triggering factors though. Fortunately it is benign and in the majority of cases doesn't repeat itself. It doesn't warrant any treatment.
The other possibility would be that of a seizure. It is less likely as seizures usually do have some signs noticeable by doctors. However seizures can take many forms so can't be completely excluded. At this point in time there is no way to confirm that as no EEG was done during the episode and now that she is back to normal it is not of much use (since she is known to be epileptic some changes may be found anyway).
Regarding the more chronic memory and concentration issues you describe they need to be assessed, so an appointment should be scheduled but it is not an emergency. The aim is of course to evaluate the possibility of dementia through appropriate neuropsychological tests. Of course you should also keep in mind that since she is a known epilepsy patient and I presume under treatment for many years there is the possibility of some cognitive changes. Both epilepsy as well as its medications over the years are associated with cognitive changes so together with aging it might be the explanation for the episodes you describe over the last years.
I remain at your disposal for other questions.
Transient global amnesia most likely.
Detailed Answer:
I read your question carefully and I understand your concern about your sister in law.
Since an MRI has been performed I agree with the doctors that a stroke or other brain lesions are to be excluded, the MRI is the most sensitive test on that regard. In fact while the lack of an explanation might seem alarming to you you should feel reassured as threatening causes can be safely excluded given those normal tests.
The most likely possibility for what happened is transient global amnesia, a sudden episode of temporary memory loss not explained by a neurological condition. It is a recognized and common diagnosis the underlying cause of which is still unknown. It is more common in patients over 50 and there are some possible triggers among which may be emotional stress such as the potential stress before a journey in this case. It might happen in the absence of any triggering factors though. Fortunately it is benign and in the majority of cases doesn't repeat itself. It doesn't warrant any treatment.
The other possibility would be that of a seizure. It is less likely as seizures usually do have some signs noticeable by doctors. However seizures can take many forms so can't be completely excluded. At this point in time there is no way to confirm that as no EEG was done during the episode and now that she is back to normal it is not of much use (since she is known to be epileptic some changes may be found anyway).
Regarding the more chronic memory and concentration issues you describe they need to be assessed, so an appointment should be scheduled but it is not an emergency. The aim is of course to evaluate the possibility of dementia through appropriate neuropsychological tests. Of course you should also keep in mind that since she is a known epilepsy patient and I presume under treatment for many years there is the possibility of some cognitive changes. Both epilepsy as well as its medications over the years are associated with cognitive changes so together with aging it might be the explanation for the episodes you describe over the last years.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
