Paging Dr. Frischer - Amnesia

Amnesia. It’s a popular theme in books and movies, but it’s actually extremely rare! Here is one example of this highly unusual condition: In 1985, 26-year-old Jody Roberts lived in Tacoma, Washington, and worked as a reporter. Roberts’ friends and family started to notice behavioral changes; she stopped taking care of herself and began to drink significantly. Just a few weeks later, she vanished. Five days later, Roberts was found wandering over 1,000 miles away, in Aurora, Colorado. She was admitted to a Denver hospital, where she was diagnosed with amnesia. Roberts took a new name and started a new life, working at a fast food restaurant, and enrolling at the University of Denver. She moved to Alaska and married, had two sets of twins, and worked as a web designer. Twelve years later, in 1997, one of her Alaskan co-workers saw her photo on a Seattle newscast and recognized her. She eventually reunited with her friends and family in Tacoma, but never recovered her memory.

Amnesia is a loss of memory, usually caused by head trauma, traumatic psychological events, or disease (including dietary and vitamin deficiencies, and alcohol, drugs, and certain medications). Some of these causes, including the use of sedatives and hypnotic drugs, can result in temporary amnesia, and the amount of the memory loss may vary.

It is important to note that amnesia is not the same as dementia. Dementia often includes memory loss, but it is seen primarily in the elderly, and also involves other significant cognitive issues.

Amnesia can be divided into two main types:

•Retrograde amnesia is the inability to recall memories before the beginning of the amnesia. The memory loss may go back decades or only weeks or months. It is usually caused by head trauma or brain damage, but other causes include stroke, tumor, hypoxia, encephalitis, and chronic alcoholism. People suffering from retrograde amnesia are more likely to remember general knowledge, rather than specifics. Older memories tend to be easier to recall, probably because they have been strengthened over time. The good news is that, unlike the story of Jody Roberts, retrograde amnesia is usually temporary and often can be helped by exposure to the lost memories.

•Anterograde amnesia refers to the inability to create new memories. Long-term memories created before the amnesia remain intact. This type of brain damage can be caused by severe malnutrition, head trauma, surgery, Wernicke-Korsakoff syndrome (most typically from alcoholism), cerebrovascular events and strokes, anoxia, or other trauma. Treatment involves the use of behavioral therapy, focused on helping patients manage daily routines.

Many forms of amnesia tend to improve over time. Cognitive or occupational therapy can help to develop new memory skills to cope with the loss. Technological aids can help, by tracking everyday tasks.

No specific medication is available to treat amnesia, but if there is an underlying medical condition, that may be treatable. This might be the case for amnesia related to thyroid disease, liver or kidney disease, stroke, depression, bipolar disorder and blood clots in the brain. Wernicke-Korsakoff syndrome, often associated with alcohol abuse, responds to thiamin replacement.

Clearly, anyone with unexplained memory loss, head injury, confusion or disorientation needs immediate medical attention.

Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

 

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Published: Oct. 23, 2014 - Volume 13 - Issue 28

Jennifer DeKay