![]() For example, studies may be performed in many countries with very different rates of revascularization procedures, making use of this as an end point very problematic. Three months after this episode, the follow-up electroencephalogram was normal. Transient global amnesia was suspected clinically and transient epileptic amnesia provoked by sibutramine was also proposed. In addition, many studies use composite end points, which include not only "hard" end points like heart attack or death (which are pretty hard to misdiagnose) but also "softer" end points like the "need" for revascularization or the occurrence of acute coronary syndromes. Electroencephalogram showed spike and wave complexes with phase reversal in the left mesial temporal area. In some studies surrogate endpoints like inflammation or artery thickness are used but a favorable change in surrogate markers does not always translate into clinical benefit. The absolute risk of a cardiac event is only reduced by a few percentage points by statins and in some patients, like the women without heart disease we just talked about, the reduction is not even statistically significant. Then, the data from the studies are usually given in terms of relative rather than absolute risk. Initially, it was thought that total resolution was achieved, but more recent studies suggest there can be some minor residual impairment surrounding the event as well as some subclinical cognitive deficits, even years later.Barbara Roberts: Yes, and of course patients will also be staying on the drugs for life unlike trial subjects. The symptoms will begin to improve within hours and memory will slowly, and almost entirely, return over the course of the next 24 hours. They will repeatedly ask the same question, as they forget they just asked the question moments before. Even with visual cues, such as pictures taken during the day, they will have no recollection of the events. They will often not recall people or locations from the past few hours and will feel disoriented as a consequence. ![]() Patients will present with no focal neurological deficits but will often not recall how they got to the hospital, that they are in the hospital, or the day's events. The symptoms are not present when the patient awakens in the morning but occur later in the day. The presence of active seizures excludes TGA, whether new-onset or chronic. There will be no history of trauma, and the symptoms will resolve within 24 hours of onset. There are no accompanying neurological deficits or other cognitive deficits. They do not lose their self-identity ability. This condition is known as transient global amnesia, now known to be associated with 'statin' drug use for lowering cholesterol. Try to imagine the complete inability to formulate new memory. They will not report a loss of consciousness. Transient global amnesia: a side effect of 'statin' treatment From Townsend Letter for Doctors and Patients, 8/1/04 by Duane Graveline. There is even growing evidence of a statin link to Lou Gehrigs disease. Most of these symptoms subside or improve when they are taken off statins. Often, the person(s) accompanying the patient will report recent activity such as vigorous exertion, coitus, or severe stress. These side effects range from debilitating muscle and joint pain to transient global amnesia, neuropathy, cognitive dysfunction, fatigue and muscle weakness. They will display repetitive questioning and have no recall of how they got where they are or what they did in the time immediately preceding the onset. Generally, these patients present with acute onset of several hours of memory loss. This activity reviews the evaluation and management of patients transient global amnesia and highlights the role of interprofessional team members in collaborating to provide well-coordinated care and enhance outcomes for affected patients. ![]() The diagnosis is largely a diagnosis of exclusion. The symptoms, once resolved, rarely recur and no other neurological deficits present with this condition. While there may be disorientation with respect to other people and location, the patients do not lose self-awareness. ![]() Patients often present with repetitive questioning and total anterograde memory loss that resolves within 24 hours. ![]() Studies have been inconclusive as to whether there are risk factors for the development of transient global amnesia, though some have suggested an association with a history of prior heart disease, migraine, or hyperlipidemia. It is often precipitated by particularly strenuous activity, high-stress events, or coitus, but it can be seen with migraines. Transient global amnesia (TGA) is acute onset anterograde amnesia that is temporary and usually occurs in middle-aged and older individuals. ![]()
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