Case reports

Case Report – Transient Epileptic Amnesia

A 58-year-old carpet fitter experienced 28 episodes of transient amnesia over 18 months. All occurred upon waking in the night and lasted about 20 minutes. He repetitively questioned his wife, but was responsive and coherent throughout. During one attack he was unable to recall the death of his brother a few days earlier. Routine EEG and MRI were normal. Lamotrigine abolished the attacks but they briefly returned, with associated olfactory hallucinations, during a period of non-compliance, and ceased again when he restarted the medication. At interview, he described rapid forgetting of recently acquired memories, patchy loss of salient autobiographical memories from the past 30 years, such as his wife’s abdominal surgery and the wedding of his son, and significant new difficulties navigating around his local area.

Case Report – Transient Global Amnesia

A 63-year-old, recently retired teacher was brought to the Accident and Emergency department by her husband. One hour earlier, she had telephoned him from the local gym where she had just finished her daily workout and said: “I don’t know where I am. What’s happening? Where am I?” Despite his reassurances, she had continued to repeat the same questions. On examination, she was disoriented in time and place, had no recollection for events of the previous week and was unable to retain new information – including the identity of the attending doctor. Besides the amnesia, there were no other neurological signs or symptoms. A CT scan of the head was normal. Over the following 6 hours, her memory deficit gradually resolved although she was left with a dense “gap” for the episode of transient amnesia itself and for the preceding trip to the gym.

Case Report – Psychogenic Amnesia

A 43-year-old construction worker was brought to hospital by colleagues. That morning, he had suffered a minor head injury when his forklift truck collided, at low speed, with an earth bank. Since then, he had a “complete loss of memory”, with no recollection of any past events. He was unable to remember his own name and failed to recognize his colleagues or, when she arrived, his recently estranged wife. Despite this, there was no apparent difficulty in learning new information – he could recount in detail the events following his arrival at hospital. MRI of the brain was normal. It later emerged that, since an acrimonious separation from his wife, he had been showing signs of depression and drinking heavily. He had suffered a period of concussion following a motorcycle accident in his 20’s.