Transient Global Amnesia: Commentary on Trip Gabriel’s First-Person Account

Case of transient global amnesia-like syndrome after recreational cold-water swimming

We document a case of a transient global amnesia (TGA)-like syndrome following open water swimming. This case was atypical for TGA, in that symptoms were prolonged and ischaemic infarct was considered within the differential. MRI did not demonstrate any changes associated with acute ischaemia although did show a mild degree of small vessel change. With amnesia taking greater than 24 hours to resolve, we have labelled this case to be a TGA-like syndrome, provoked by the commonly reported TGA precipitant of cold water immersion. The possibility of a tiny, strategic infarct causing these symptoms was considered and antiplatelet therapy commenced.

The History of Amnesia-a Review

PURPOSE OF REVIEW

This review traces amnesia's history from its earliest eighteenth century classification as a medical disorder to the present. Sophisticated depictions in the nineteenth century literature containing elaborate compilations of causal factors, including neurologic, consider pathogenesis, course, duration, durability, and temporal features.

RECENT FINDINGS

Severe amnesia, especially anterograde involving new learning, found archetypal expression in the twentieth century, in the case of H.M. The "pure" amnesia confirmed an independent memory disorder distinct from other cognitive disturbances, with functional dissociations illustrating nuanced manifestations and highlighting the role of some discovered structural correlates (e.g., hippocampal and associated MTL regions). Moreover, neural networks and interconnections have also notably been implicated. Although concepts of illness change across cultures and centuries, portrayal of amnesia remained consistent as it spread internationally. Amnesia's groundbreaking original nosology laid a foundation for contemporary paradigms of the multifactorial nature, specificity, and complexity of a poignantly thought-provoking disorder.

The Day That Went Missing: A First-Person Account of Transient Global Amnesia

In this vivid first-person case history, political reporter Trip Gabriel describes experiencing a classic episode of transient global amnesia. He was near the average target age of 61. Although no cause has been established for the syndrome, as with many other patients his episode appears to have been triggered by contact with water: He was racing a sailboat. While remaining alert and handling complex sailing maneuvers, he suddenly developed amnesia that left him with no recollection of finishing two races, returning to shore, drinking a beer with his friends, needing help finding his car, and not knowing where he was or where he lived. When he did not arrive home on time, his wife called him and quickly recognized his disorientation. She helped him drive himself home and took him to the hospital, where he was evaluated for a stroke. A brain magnetic resonance imaging scan was normal. He started to become aware again about 9 hours after the start of the attack, but was kept in the hospital until his anterograde amnesia resolved fully about 23 hours after onset. He has no memories of 12 hours (from 3 hours before the attack started through the time he regained awareness in the hospital). He was reassured to learn that a recurrence is unlikely. He finds parallels to his experience in the films Memento and Inside Out. A companion article provides expert commentary on the case report (Kirshner HS. 2017. Cogn Behav Neurol. 30:5-7).