Transient Global Amnesia (TGA) is a sudden onset, but temporary neurological episode of memory loss.¹ Usually, TGA will not leave the patient suffering any long-term effects.² However, the episode may cause distress and confusion for you and your loved ones. It is important to understand how to manage and alleviate symptoms, which will ensure adequate care and reduced anxiety around TGA. This article outlines the best practices for handling TGA episodes, what you can do if you or someone you know experiences TGA, as well as details on the symptoms, causes, and development of the condition. 

There is no established, evidence-based treatment for TGA, but symptoms usually resolve on their own within 24 hours.¹ Treatment and management should prioritise supportive care and minimising distress during and following the episode.^3,4

Treatment and immediate management

• Reassurance and supportive care: The best approach is to keep the individual calm and reassured. A supportive and stress-free environment can help to minimise additional distress and confusion. Clear and simple communication is key.⁴ Avoiding overstimulation and speaking in a calm tone can help to ensure this 
• Medical evaluation: Seeking medical attention is recommended in order to rule out more serious conditions.¹ A doctor may conduct neurological exams, blood tests, or imaging to ensure there are no underlying conditions contributing to the episode⁵
• Observation of episodes: Keeping track of episodes can help identify potential triggers and assess whether recurrence occurs. This can provide helpful insights to aid future management. Keeping a symptom journal or using a mobile app can help to track patterns over time 
• Rest and Hydration: Rest and hydration will support the body’s natural recovery and is important to prioritise after a stressful episode 
• Consider intravenous thiamine: Some studies suggest that a dose of 100 mg i.v of intravenous thiamine may be beneficial in select cases, particularly if the person has a history of alcohol misuse or nutritional deficiencies.^7,8 However, more research is needed to determine its effectiveness 

Reducing the risk of future episodes

Given that is no single definitive cause of TGA, prevention is difficult.¹ However, there are a number of ways you can manage lifestyle factors to reduce the risk of an episode: 

• Stress management: Physical and psychological stress can contribute to TGA, so incorporating healthy coping mechanisms such as mindfulness and relaxation techniques may help reduce the risk of recurrence and can improve overall resilience against neurological events⁴
• Avoiding potential triggers: Identifying and avoiding known triggers (eg, intense physical exertion) can help reduce the risk of recurrence. Keeping a diary of potential triggers can assist in understanding what may provoke an episode¹
• Healthy lifestyle choices: Regular exercise, a balanced diet, and avoiding smoking can support overall neurological health and potentially reduce risk factors¹ 
• Education and awareness: Educating you and your family about TGA can help reduce fear, and empower the recognition of early warning signs. Awareness in community health settings can also help individuals seek timely medical attention when needed⁶
• Collaborative Care Plan: Open communication between patients, caregivers, and healthcare providers can ensure a smooth recovery and reduce anxiety 

While TGA can be distressing in the moment, understanding its temporary nature and focussing on reassurance and medical evaluation can ease concerns. By adopting healthy lifestyle choices and managing stress effectively, individuals may reduce the likelihood of recurrence and promote overall brain health. 

Want to understand more about TGA, its causes, symptoms, and prognosis? Keep reading as we break down everything you need to know, including risk factors, diagnosis, and what to expect during recovery. 

Understanding Transient Global Amnesia 

Transient Global Amnesia is a neurological event that presents itself as sudden memory loss, during which the person cannot create new memories or recall recent events. However, personal knowledge and identity remain intact. On average, episodes last 6 hours.⁷ 

The episode is characterised by Anterograde Amnesia, which refers to the inability to form new memories and Mild Retrograde Amnesia and Confusion, which means people will have difficulty recalling recent events before the episode.¹ 

Although there is a permanent gap in memory for the episode’s duration, there are typically no other lasting effects or complications. 

Symptoms and key features

TGA symptoms primarily revolve around sudden memory impairment, often leading to confusion and disorientation:⁶

• The sudden inability to form new memories (Anterograde Amnesia)
• Difficulty recalling very recent events (Retrograde Amnesia) 
• Confusion and disorientation
• Obscured time perception 
• Repeating basic questions about immediate surroundings (e.g: date, time, and location)

Less common symptoms include:¹

• Vomiting 
• Headache
• Blurry vision 

Importantly, TGA is NOT associated with:⁹

• Recent head trauma 
• Loss of language abilities
• Restricted movement or paralysis 
• Loss of consciousness 

Clinically, the presented symptoms suggest that the “medial temporal lobe” and the “hippocampus” (most often the left side) are the associated sites of neurological involvement.⁸ 

On average, an episode will last around 6 hours, but can range from 1 to 24 hours.¹⁰ 

If you, or someone you are with is experiencing these symptoms, seek medical advice to rule out other conditions. 

Causes and triggers

The exact cause of TGA remains unknown, but research suggests several factors may contribute to triggering an episode. 

Established Association: 

• A history of migraines: At present, a medical history of migraines is the only confirmed risk factor associated with TGA^1,6,11

Common Triggers:

• Physical Stressors: Intense exertion, sexual intercourse, Valsalva maneuver, rapid temperature changes, acute illness²
• Emotional and Psychological Stressors: Significant life events, financial pressure, grief, family problems² 
• Stressful events: Both positive and negative can trigger an episode. 

Studies suggest the following may also be possible risk factors:⁶

• Hypertension
• Ischemia 
• Hyperlipidemia

Who does TGA affect?

TGA primarily affects middle age-older adults and can be more common in those with certain medical histories: 

• Most common in ages 50-70 
• Rare in individuals under 40 
• No significant gender differences 
• Increased risk in those with a history of migraines 
• Some studies suggest links to ischemia and hyperlipidemia⁸ 

TGA affects approximately 3 to 8 people per 100,000 each year. This increases to 24 per 100,000 in people over 50 years old.³

Diagnosis 

Diagnosing TGA is challenging and often missed in up to 90% of initial assessments¹. Many symptoms overlap with other medical conditions. 

There is no single test to confirm TGA; therefore diagnosis relies clinical history, and on eliminating other possible conditions, including:⁵

• Neurological Exams
• Blood Tests
• Brain Imaging (MRI, CT scan) 

Prognosis and Recurrence 

The good news is that TGA is usually a unique, one-time event and most individuals will recover fully within 6-24 hours.¹² Following the episode, individuals will form new memories as normal, however they will not recall any events that took place during the episode. 

Full recovery from an episode within 24 hours is the norm, and recurrence is rare but still possible. Less than 10% of those who experience TGA will incur another episode.¹² If multiple episodes occur, you should seek further medical evaluation to assess any underlying or associated risk factors. 

Summary

Transient Global Amnesia is a temporary and generally harmless neurological event that causes a sudden but short-term memory loss. While the exact cause remains unclear, factors such as migraines or increased stress may provoke an episode. Most individuals recover fully within 24 hours, and recurrence is rare. Managing TGA involves reassurance, medical evaluation, and identifying possible triggers. If symptoms persist, or multiple episodes occur, further medical assessment is recommended. 

FAQs

Can TGA lead to permanent memory loss?

No, TGA does not cause permanent memory loss. However, patients typically do not recall events that occurred during the episode itself. Most patients recover fully within 24 hours.¹

In very rare cases, prolonged memory issues may occur - usually only in individuals who may have experienced recurrent episodes.³

Is TGA linked to Alzheimer's disease or dementia? 

No, TGA is not a sign of Alzheimer's disease or dementia, and is not believed to increase the risk of developing these conditions.¹¹ 

Will an episode of TGA increase my likelihood of having a stroke?

No, having 1 or more episodes of TGA does not increase the risk of having a stroke (cerebrovascular event).¹¹ It is also important to note that a TGA episode is not a ‘mini stroke’. 

What should I do if someone is experiencing a TGA episode?

Stay calm, and try to minimise any stress occurring in the surrounding environment. Reassure the person, and seek medical attention to rule out other conditions.