On the physical examination in the ED, the patient’s blood pressure was 162/81 mmHg, pulse was 71 beats per minute, temperature was 98.4☏, respiration was 18 breaths per minute, and oxygen saturation was 96% on room air. The patient denied any tobacco, alcohol, or recreational drug use. Surgical history was significant for unspecified foot surgery in the remote past. On a mini-mental status examination (MMSE), the patient was unable to answer the current year, president, or home address. The patient did not have any past medical history, similar episodes of memory loss, and currently, he was not on any medications. Upon initial evaluation in the ED, there was no obvious facial asymmetry or unilateral weakness, and the blood glucose level was 100 mg/dL. There was also no history of traumatic brain injury, cerebrovascular accidents, dementia, seizures, psychiatric illnesses, or previous similar episodes. There was no head injury, limb weakness, paralysis, changes in vision, headache, chest pain, shortness of breath, nausea, vomiting, or any other physical complaints at the time, but it was noted to be a hot day. The rest of the review of systems was insignificant. At 12:04 PM, he presented to the emergency department (ED) with his son, who was the primary historian and translator for the patient. Upon being questioned, he was unable to report the last thing he could remember. Prior to this episode, his behavior was noted to be normal. He was unable to identify his cousin and confused him for his son. While on his break, he suddenly became confused and began repetitively asking, “where are we?” and “what happened?” The patient had forgotten where he lived and who he was working with. Here, we present a rare case of TGA in this study.Ī 62-year-old male presented with the chief complaint of confusion and memory loss that occurred at 9:50 AM, while at work. At the time of the episode, the patient was working his regular job at a fiberglass factory with his son and cousin. Less prominently, but still present, patients display retrograde amnesia and are therefore also unable to recall information that occurred hours, days, months, or even years before the attack. During an attack, patients are unable to encode new information and transform it into long-term memory, therefore, they repeatedly ask questions about their surroundings. This syndrome is demonstrated by a sudden disturbance in memory which resolves in 24 hours or less. This syndrome is characterized by a loss of anterograde memory, that is, the inability to form new memories, with a less prominent loss in retrograde episodic memory which includes recognition and executive function. TGA commonly presents in the seventh decade of life with the mean age range from 61 to 67.3 years, according to Spiegel et al. Transient global amnesia (TGA) is a rare clinical syndrome with an incidence of 5.2-10/100,000 per year in the general population and 23.5-32/100,000 in individuals greater than 50 years old.
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