Title : A Case of Transient Global Amnesia Triggered by Sexual Intercourse.

Abstract:

Transient global amnesia (TGA) involves a sudden onset of anterograde and retrograde amnesia, often accompanied by executive dysfunction, typically lasting up to 24 hours, and not linked to another neurological impairment.

Case Presentation:

A 52-year-old right-handed man presented with confusion and retrograde amnesia starting during the morning of presentation. He had been driving on a long road trip the previous day without alteration of consciousness, but subsequently forgot a period of a few hours during the trip. On initial evaluation in the Emergency Department, he had poor short-term memory and could not state the current year or president, nor his home address. He had no signs of stroke on exam. He denied any chronic medical conditions or medications. He notably experienced headache during sexual intercourse after the trip and before he first complained of amnesia. A CT brain scan four hours after onset of amnesia revealed no acute intracranial abnormalities. A MRI brain scan 13 hours after onset of amnesia demonstrated only a right hippocampal punctate focus of diffusion restriction. On exam 24 hours after presentation, the patient had full short-term recall, and was oriented to person and place, but not to date.

Discussion:

The cause of TGA is uncertain despise its widespread recognition as a clinical entity. It has been linked to vascular risk factors, migraine, and epilepsy. Bilateral hippocampal ischemia has been hypothesized as a probable cause of transient loss of declarative memory, while migraines and epilepsy have been suggested as possible TGA correlates.

Conclusion:

While TGA is uncommon and has a favorable prognosis, it can be seen in typically healthy individuals with no medical comorbidities. This case reveals the presence of sexual intercourse as a probable trigger for TGA, or alternatively a trigger for new-onset migraine which itself is a known TGA correlate. This unique presentation of TGA can guide clinicians in the future on identifying relevant risk factors for an accurate diagnosis of TGA.

What will the audience learn from your presentation?

1. Describe the typical clinical features of transient global amnesia.
2. Identify typical neuroimaging findings associated with transient global amnesia.
3. Outline the differential diagnoses and clinical correlates for transient global amnesia.

Biography:

Dr. Askar graduated medical school at Faculty of Medicine, Alexandria University, Egypt in 2016. She then worked as a teaching assistant at Microbiology and Immunology Department Faculty of Medicine, Alexandria University for 2 years, during which she finished her USMLE exams and then joined the Internal Medicine Residency training program at Department of Internal Medicine, Northwell/Hofstra Zucker School of Medicine, Long Island Jewish Forest Hills, NY, USA. She was honored to be the intern of the year during her first year of residency 2020-2021. She then was chosen by her program to be the chief resident during her third year of residency 2022-2023. 

Throughout her medical school, she was a member of “Future Doctor Society” which is a non-governmental organization in Egypt aiming to improve the health care system. She participated in many fundraising projects, campaigns, and social events.