What is amnesia

amnesia

ICD-10-GM-2020 F04, F44, R41 + G45.5

What does medicine understand by amnesia?

Medicine calls amnesia a loss of memory. Depending on the type, cause and course of the disease, doctors differentiate between numerous different forms of amnesia. Each form has its own characteristics and symptoms, but many of them also overlap. Depending on the severity and trigger, the respective forms have very different effects on the patient. Some forms of amnesia are incurable. In other forms, the symptoms disappear on their own within some time or as soon as the trigger has been successfully treated.

What types of amnesia are there?

There are many different forms of amnesia in medicine. Differentiating criteria are the period of time that is affected by the memory loss, the cause, as well as the form and extent of the amnesia.
 
In the case of anterograde amnesia, the person affected can only store minimal or no longer any new information. It is the most common form of amnesia. If there is no memory of the time before the memory loss, it is retrograde amnesia.
 
With global amnesia, past experiences and new content are difficult to access. However, skills such as cycling are retained. This form of amnesia is usually not curable.
 
A transient global amnesia affects all memory contents, regardless of whether they happened long ago or recently. Skills learned are retained. This type of memory loss usually disappears on its own within 24 hours.
 
In congrade amnesia, memory loss is limited to the triggering event, for example an accident. Psychogenic amnesia describes the loss of memories of traumatic experiences. The cause is the unconscious repressing of the memory of it.

How is anterograde amnesia expressed?

This type of amnesia is the most common and is also called forward amnesia. It is hardly possible for the person concerned to save or call up new memory contents. While long-term memory is usually severely impaired in this form, short-term memory works without major problems. Thus, the patient can usually cope with everyday life alone. Patients can also remember the time before the onset of amnesia.

How do doctors recognize retrograde amnesia?

Retrograde amnesia is retroactive memory loss. This means that the person concerned has no memories of the time before the amnesia. In most cases, the trigger for retrograde amnesia is brain trauma. Retrograde amnesia often goes away on its own after a few seconds or minutes. However, it can also last for several weeks or months.
 
The extent of the brain damage does not affect how long the symptoms persist. Many patients forget events that occurred shortly before the injury more quickly than events that occurred a long time ago. Even if the memories come back over time, not all memory contents often come back. In addition to retrograde amnesia, many patients also have symptoms of anterograde amnesia.

What is global amnesia?

The most severe form of memory disorder is what medical professionals call global amnesia. For those affected by global amnesia, it is no longer possible to recall memories of events that were years or decades ago. In addition, it is no longer possible for them to record and save new content in their memory. It is no longer possible to learn new content.
 
That part of the memory that is responsible for skills, the procedural memory, remains intact. Those affected can continue to operate a car without any problems, but they lack the ability to orient themselves. This form of amnesia is usually not curable.

How does transient global amnesia manifest itself?

Transient global amnesia (TGA) occurs suddenly and usually disappears just as quickly. There are no consequential damages. In most cases the symptoms go away on their own within 24 hours. Doctors also speak of episodic amnesia in this case.
 
This shape looks both forward and backward. This means that it is not possible for the person concerned to memorize new content. They don't know where they are or what the date is. Past content is also no longer available to those affected. This form of amnesia does not affect procedural memory either. Skills that were learned before the amnesia occurred can still be carried out by the person concerned.
 
The majority of those affected by transient global amnesia are between 50 and 70 years old. In around three quarters of those affected, emotional-psychological or physical stress, jumping into the cold water or having sex are the cause of transient global amnesia.

What are the signs of congrade amnesia and psychogenic amnesia?

With congrade amnesia, only the memory of the event that caused the amnesia disappears. This could be an accident or a strong blow to the head, for example. The person concerned has neither problems remembering what happened before the triggering event nor storing new content in memory. Psychogenic amnesia is similar. The affected person suppresses the memory of a traumatic experience.

What are the causes of amnesia?

There are numerous triggers that can lead to amnesia. Amnesia can also be a side effect of various other diseases. In general, medical professionals differentiate between psychogenic and organic causes.
 
Psychogenic causes are psychoses or extreme emotional stress that can be traced back to a traumatic experience. The patient represses the experience until at some point he can no longer remember it.
 
Organic causes, on the other hand, are either a disorder in the brain or damage to the brain tissue. Organic amnesia can be triggered by accidents with traumatic brain injury or a concussion. Inflammation of the meninges (meningitis) or inflammation of the brain (encephalitis) can also lead to amnesia, as can a stroke or migraine.
 
But poisoning, long-term alcohol abuse and certain medications such as psychotropic drugs or barbiturates can also lead to memory loss. Diseases that can lead to amnesia include, for example, dementia, alcoholism, traumatic brain injuries, epilepsy, strokes or dissociative disorders.

Which risk factors favor amnesia?

Behaviors that are harmful to health promote the development of amnesia. These primarily include the consumption of alcohol and smoking.

When should i go to the doctor?

You should go to the doctor if it happens frequently that you can no longer remember the past. The same applies if you notice that you often have problems retrieving newer information. Amnesia can be caused by a condition that requires treatment. The earlier you go to the doctor, the better the treatment options.

How does the doctor diagnose amnesia?

As with every medical examination, a detailed discussion with the doctor takes place at the beginning. In this, he clarifies when you first noticed the memory loss. He asks you about other possible illnesses you are suffering from, what medication you are taking and whether there is a possible connection between the amnesia and a certain event, for example an accident. Observations from friends and family are also important in diagnosing amnesia. Often this is the only way for the doctor to determine unequivocally what type of amnesia it is.
 
If amnesia is suspected after this interview, various memory tests are carried out. For example, the person affected has to repeat increasingly long series of numbers from memory in order to check the function of the short-term memory.
 
Imaging methods such as magnetic resonance imaging (MRI) or computed tomography (CT) can also be used to diagnose amnesia. This allows the doctor to check for a bruise, cerebral hemorrhage, tumor, or other injury that may have caused the memory loss.
 
With a special CT procedure, the single-photon emission computed tomography, the doctor can test whether all areas of the brain are supplied with sufficient blood. To do this, the doctor injects a contrast medium into the brain and thus gets a clear picture of the condition of the tissue. The doctor uses an electroencephalogram (EEG) to measure the brain waves and can thus determine whether epilepsy is the cause of the amnesia.

What therapy is used for amnesia?

The therapy for amnesia depends on the cause. The foundation stone of the treatment is the therapy of the trigger, for example epilepsy, a stroke or dementia. If the cause is traumatic brain injury, the doctor must treat it accordingly.
 
If the trigger is emotional trauma, psychotherapeutic treatment is recommended. Depending on the patient and previous history, either behavioral or depth psychological procedures are used. Relaxation techniques such as autogenic training or yoga have also proven helpful in treating amnesia.

What can I do myself if I have amnesia?

Unfortunately, preventing amnesia is not possible. However, if you have amnesia, there are some things you can do to help improve symptoms. Activities that train your memory are particularly helpful. Special exercises with which you can train your memory are now available, for example, as an app for your smartphone.

Relaxation exercises, social contacts, movement and music also have a positive effect on the brain and memory performance. There are also self-help groups for those affected.
 
Amnesia can also be related to calcification of arteries in the brain. For this reason, you should pay attention to a healthy and balanced diet. Eat lots of fresh fruit and vegetables and avoid consuming animal fats if possible. Make sure you eat enough foods that are high in fiber and rich in vitamins. Avoid drinking alcohol and cigarettes as much as possible.

What are the consequences of amnesia for those affected?

A sudden loss of memory is frightening and threatening. The affected person loses his or her ability to orientate and no longer knows where he is or what date we are writing. This has a frightening effect on the person concerned. Complex skills, such as driving a car or cycling, are not lost, however. The personality of the person concerned also usually remains unchanged.
 
Especially people with retrograde amnesia often show no feelings. Sometimes patients appear slightly depressed or indifferent. This is because patients are unsure of how they used to behave in certain situations. For those affected, the exchange in self-help groups is often a great support.

What are the consequences of amnesia for relatives?

Amnesia can also have an impact on a person's social environment. Affected people often tell the same thing over and over again because they can no longer remember having already said it. It is important not to lose patience and to be aware that the person's behavior is conditioned by the disease. An understanding and loving environment is important for the therapy to be as successful as possible.

What is the prognosis for amnesia?

The course of amnesia differs greatly depending on the form and trigger. Cure is not possible in the case of severe organic damage, such as occurs in dementia. In this case, it is only possible to slow the progression of symptoms. With other causes, the symptoms often disappear as soon as the underlying disease has been successfully treated.
 
Thus, the prognosis of amnesia after an accident is better than that of dementia. The more supportive offers the person concerned makes use of to encourage memory processes, the better the prognosis.

What diseases can memory loss indicate?

Amnesia is often a symptom of another underlying disease. Possible diseases that lead to memory loss are, for example, dementia, epilepsy, a stroke, meninges or encephalitis, dissociative disorders or Korsakoff's syndrome.

Does the health insurance company cover the costs for amnesia treatment?

The health insurance company pays for the diagnosis and treatment of amnesia. A deductible may apply depending on the insurance company. You can obtain more detailed information on this directly from your treating doctor or health insurance company.
 
If an operation is necessary, a stay in hospital is also necessary. The health insurance company only partially covers the costs of a hospital stay. There is also normally a deductible for psychotherapy. You can obtain information about the amount of the deductible from the attending doctor or the health insurance company.

 


About the author: Dr. med. Maximilian Strenkert

Specialist in internal medicine


Dr. med Maximilian Strenkert studied medicine in Munich, Erlangen and Verona. During his specialist training as an internist at the Munich-Bogenhausen and Herrsching Hospital, he dealt with all areas of modern medicine and learned a variety of diagnostic and curative methods. He worked as an emergency doctor in Herrsching for many years. His specialties are diseases of the cardiovascular system, metabolic diseases such as diabetes mellitus (diabetes), diseases of the gastrointestinal tract, ultrasound (abdominal organs, thyroid, heart, blood vessels). He has been to Lebanon and Costa Rica several times for humanitarian purposes and does voluntary work for disabled people as a doctor.

In cooperation with the Carl-Korth-Institut Erlangen for occupational medicine, one of the leading inter-company occupational medical service providers in Germany, he has been working as a company doctor for many years. He is a member of the Association of German Internists (BDI) and the German Society for Internal Medicine, the German Society for Tropical Medicine and Global Health (DTG) and the Association of German Company and Company Doctors (VDBW).