OBJECTIVES: To review the clinical aspects, new imaging findings and recent clinicoepidemiological data with regard to the phenotype, functional anatomy and putative cellular mechanisms of transient global amnesia (TGA). Despite several new hypotheses concerning the pathogenesis of TGA, there is still not consensus about its cause. Herein, the evidence in support of and against the main pathogenic hypotheses are critically evaluated. METHODS: Relevant literature published since the first reports of TGA published in 1956 is reviewed, with the aim of accurately describing the demographic and clinical features of TGA. A systematic review of the literature on the relationships between focal ischaemia, migraine, epileptic phenomena, venous flow abnormalities and TGA was performed by searching the literature for all relevant studies. References were identified through searches with the search terms 'amnesia', 'transient global amnesia', 'TGA', 'hippocampus' and 'CAI'. Only papers published in English were included. RESULTS: Classical proposals about its possible aetiology (epilepsy, vascular disease and migraine) and other new theories (Leao 's spreading depression or influence of stress) have been assessed. While there is data in favour and against hypotheses of the aetiology of TGA, there is no current consensus which satisfactorily explains the nature of this type of amnesia. A number of recent neuroimagmg studies suggests involvement of the mesial temporal area (amygdala and hippocampus) and/or thalamus leading to transient disruption of blood flow, and appearing as focal magnetic resonance (MR) hypenntensities showing restricted diffusion on diffusion-weighted MR imaging (DW-MRI). CONCLUSIONS: TGA is defined as a selective deficit of memory that appears suddenly and lasts less than 24 hours. The present state of knowledge about memory deficits associated with TGA is still limited, and there are still several aspects that require clarification, particularly regarding recovery. Recent neuroimaging findings suggest that transient perturbation of hippocampal function is correlated with TGA, as focal lesions can be reliably detected in the CAI field of the cornu ammonis with DW-MRI. Tuture research should focus on elucidating the pathophysiological correlates of the acute phase, particularly on deciphering which trigger induces the pathophysiological cascade that affects CA I neurons. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Professor Ritchie Russell`s monograph maintains the high standard and high degree of interest established by the other contributors to this series. His early work, founded on detailed studies of head-injured patients was published in early 1930s. Since then has gone on to develop his concepts of memory, learning, and amnesia in the ligth of experience and expanding biological knowledge. Some of the earlier papers are no longer easily avaible; annotated extracts from these, toghether with more recent contributions, are presented in this volume.

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Patients, when admitted to an intensive care unit (ICU), have one thing in common: their illness is life-threatening. Patients may remain on ICU in a critical condition, needing support with their breathing, circulation, and/or kidneys for varying lengths of time, from days to weeks. During that time the patients will receive sedative and analgesic drugs to ensure compliance with artificial ventilation. Patients recovering from critical illness frequently have little or no recall of their period in ICU, or remember nightmare, hallucinations, or paranoid delusions. The nature, extent and reason for these difficulties, have been under-reported and consequently our purpose was to conduct a review of memory problems experienced by ICU patients. A systematic literature review of computer databases (Medline, PsycLit, and CINAHL) identified 25 relevant papers. In addition, other relevant articles were obtained, citation lists and associated articles retrieved. Due to lack of research on processes underlying memory problems in ICU patients all articles that introduced an insight into possible mechanisms were included in the review. There seem to be two possible processes contributing to memory problems in ICU patients. First the illness and treatment may have a general dampening effect on memory. Delirium and sleep disturbance are both common in ICU patients. Delirium can result in a profound amnesia for the period of confusion. Sleep deprivation exacerbates the confusional state. Slow wave sleep is important for the consolidation of episodic memories. Treatment administered to patients in ICU can have effects on memory. Opiates, benzodiazepines, sedative drugs such as propofol, adrenaline, and corticosteroids can all influence memory. In addition, the withdrawal of drugs, such as benzodiazepines, can cause profound withdrawal reactions, which may contribute to delirium. Second, we hypothesise that there is a process that affects memory negatively for external events but enhances memory for internal events. The physical constraints and social isolation experienced by ICU patients and the life-threatening nature of the illness may increase the experience of hypnagogic hallucinations. Attentional shift during hypnagogic images from external stimuli to internally generated images would explain why ICU patients have such poor recall of external ICU events, but can clearly remember hallucinations and nightmares. Patients describe these memories as being very vivid and this is explored in terms of flashbulb memory formation. The absence of memories for real events on ICU can result in ICU patients remembering paranoid delusions of staff trying to kill them, with little information to reject these vivid memories as unreal. This has implications for patients' future psychological health.

A questionnaire is described and data are analyzed from 1000 young adults who retrospectively reported on features of memory lapses associated with head injury with loss of consciousness as it may have occurred in their lifetimes. It was found that 24% of the males and 16% of the females claimed a former head injury with loss of consciousness. Lengths of retrograde amnesia, post-traumatic amnesia, and the length of time that had passed since the head injury are shown to be related to each other.

The cognitive symptoms that characterise the Wernicke-Korsakoff's syndrome include anterograde amnesia, confabulation, temporal–spatial disorientation, severe apathy, poor awareness of one's own mental state and changes in executive functions. Such deficits may persist even after the clinical profile stabilises. There are no studies that report an intervention after the acute phase, possibly due to the complexity of these cases. This study provides a descriptive analysis of neuropsychological rehabilitation concomitant to the neurological and psychiatric treatment of a woman who presented the symptoms described by Korsakoff. The intervention focused on reducing the impact caused by the cognitive and behavioural sequelae in the patient's daily life. It described a 25-week neuropsychological program, providing education and compensatory strategies for the patient, and also orientation and support from 2 professional caregivers and family members. Quantitative and qualitative measures were used to evaluate the effect of the intervention on memory efficacy, emotional state and social participation. Both caregivers reported a decrease in the frequency of memory lapses after treatment. Positive changes were also seen in self-care, activities at home, decision-making and participation in social activities. It is concluded that this case achieved results through the collaboration between members of an interdisciplinary team and caregivers providing daily support.

To assess the duration of post-traumatic amnesia (PTA) in children, a new procedure is described, derived from a method described previously for adults. The procedure was tested on 70 healthy children between 3.5 and 10 years of age, then applied in a longitudinal prospective study of 54 children with brain damage resulting from closed head-injury. The procedure consistently measured PTA in children of various ages. The duration of PTA was found to be as good a prognostic indicator for the occurrence of long-term residual sequelae as is duration of coma.

Our earlier retrospective study presented a formula relating lengths of retrograde amnesia to length of post-traumatic amnesia (PTA) and length of time since injury (Crovitz, Horn and Daniel, 1983). The earlier study derived the formula from 27 cases with retrograde amnesia. The present study adds another 75 cases, and we discuss similarities and differences between the two samples.

This study compared the effects of live, taped, and no music, on agitation and orientation levels of people experiencing posttraumatic amnesia (PTA). Participants (N = 22) were exposed to all 3 conditions, twice over 6 consecutive days. Songs used in the live and taped music conditions were identical and were selected based on participants' own preferred music. Pre and posttesting was conducted for each condition using the Agitated Behavior Scale (Corrigan, 1989) and the Westmead PTA Scale (Shores, Marosszeky, Sandanam, Batchelor, 1986). Participants' memory for the music used was also tested and compared with their memory for pictorial material presented in the Westmead PTA Scale. Results indicate that music significantly reduced agitation (p <.0001) and enhanced orientation (p <.001) however, the difference between live and taped music was not significant (p =.7). The mean number of pictures in the Westmead PTA scale recalled was 0.84 and the mean number of music selections recalled was 1.22 but this difference was not significant (p =.7). However, the trend suggests that music selections are more easily encoded in memory and then retrieved on request, than that of pictures. Analysis of responses in a follow-up assessment questionnaire showed that 77% of participants recalled the music program while in PTA, indicating that it reached the memory threshold. Sixty-four percent recalled the live music and 55% recalled the taped music condition however this difference was not significant (p =.7). Results suggest that music therapy programs have an important role to play in the management of people in PTA.

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