Amnesia • How does memory loss occur?

Amnesia is a partial or total loss of memory that can occur temporarily or permanently. Both organic and inorganic triggers can be considered as the cause. What forms and what treatment options are available.

Amnesia is not a disease, but the symptom of a functional impairment of the brain. An amnesia is more than just forgetfulness: In the worst case, the temporal and content-related memory loss is irreparable and leads to nursing care.

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Definition: forms of amnesia

There are various forms of amnesia that cannot be strictly differentiated. Often there are several forms of amnesia at the same time or there is an overlap.

Retrograde amnesia

Retrograde amnesia (retroactive amnesia) means the loss of the ability to remember past experiences. Affected people are unable to retrieve information that occurred prior to a particular event (such as an accident, trauma, or epileptic seizure) that triggered the amnesia.

Often, retrograde amnesia is erased from memory only a few minutes to a few days before the triggering event. But it is also possible that several years to decades disappear from memory. If this is the case, the person concerned also loses part of his personality and has to start his life more or less again.

Anterograde amnesia

In contrast to retrograde amnesia, memory loss in anterograde amnesia (forward-acting amnesia) relates to the future. Both sides of the hippocampus, which lies in the temporal lobe, are usually affected. This form, which primarily affects long-term memory, is most common among amnesias.

In the event of an anterograde memory loss, those affected cannot save new experiences from short-term memory in long-term memory. However, since short-term memory mostly remains intact, people with retrograde amnesia can usually cope with everyday life as normal.

Dissociative amnesia

Dissociative amnesia is a mental illness that belongs to dissociative disorders. The memory gaps of dissociative amnesia can also be a symptom of other dissociative diseases. Those affected do not have memories of mostly traumatic events, which means that the dissociative form of amnesia represents a protective reaction of the body. People with dissociative amnesia are often at greater risk that future, particularly stressful experiences will trigger further amnesias.

The memory gaps in dissociative amnesia range from minutes to decades. In some cases, those affected are not aware of their limited memory, negate it, or downplay it in order not to have to deal with the traumatic experience.

Global amnesia

Global amnesia is defined by doctors as the most serious form of amnesia. It is not curable and affects both long and short-term memory. Those affected by global amnesia cannot remember the past and at the same time notice nothing new, which makes normal life almost impossible.

Only the part of the memory that is responsible for action sequences (procedural memory) is spared from global amnesia. Those affected could theoretically still do everyday things, but not orient themselves.

Transient Global Amnesia (TGA)

In transient (temporary) global amnesia, memory is only temporarily impaired. This form of amnesia occurs increasingly between the ages of 50 and 70. Both anterograde and retrograde amnesia show up very suddenly in a very massive memory disorder, which can be very worrying for those affected.

The TGA causes episodic dusk conditions for a maximum of 24 hours, which then disappear on their own. Impressions can only be saved for a maximum of three minutes, which leads to disorientation with regard to space and time and the surrounding situation.

Although little research has been done into transient global amnesia, primarily because of its short duration, it is known that its cause is a temporary dysfunction of the hippocampus. This is triggered, for example, by excessive alcohol or drug use or other physical and psychological stress (for example pain).

However, the TGA is considered harmless and leaves no permanent damage.

Congress or psychogenic amnesia

With congressional amnesia, also called psychogenic amnesia, the loss of memory is limited to a psychologically or physically traumatic event. All other past experiences remain unaffected by psychogenic amnesia and new information and experiences can also be stored in the memory as normal.

Infantile amnesia

Infantile amnesia is the phenomenon that adults cannot remember from early childhood. Infantile amnesia has no disease value and affects practically everyone.

Causes of amnesia

Amnesia can be based on an independent disease, but external influences such as medication are also possible causes of lesions in the hippocampus, which are responsible for the impaired memory function.

Causes of amnesias at a glance:

  • Hypoxia (lack of oxygen supply) in certain areas of the brain

  • stroke

  • Thiamine deficiency (vitamin B1), for example due to chronic alcohol abuse or severe malnutrition

  • Traumatic brain injury, such as from a car accident

  • Seizures, such as epilepsy

  • Encephalitis (inflammation of the brain caused by viruses, bacteria or fungi)

  • Ischemia (anemia) in the anterior medial temporal lobes

  • degenerative dementias, for example Alzheimer's

  • Poisoning

  • Alcohol, drug and drug abuse

  • Psychological or physical trauma

  • Brain tumors

  • migraine

  • Meningitis (inflammation of the meninges)

  • Electro convulsion therapy

  • stress

Diagnosis: Behavior when amnesia is suspected

Do not hesitate to see a doctor if you find that you can remember the past less well than before or remember new things less well. There may be a disease behind it that needs to be treated to prevent or at least slow down further memory loss.

Sometimes an amnesia is not noticed by those affected, which depending on the cause and form of the amnesia often has no negative effects. However, if relatives are worried or notice that the affected person is affected by the memory deficits, they should seek advice from the affected person and consult a doctor.

To make a diagnosis, the doctor will first ask about the patient's medical history (medical history). He inquires about possible triggering causes such as trauma, illnesses or substance abuse.

The functions of short and long-term memory are then tested. The patient should remember numbers and words, draw, calculate and complete simple tasks. In addition to the memory tests, there is a systematic survey, often using standardized questionnaires.

In order to rule out organic diseases as the cause of amnesias, further diagnostic methods are indicated. Injuries and tumors as well as the blood supply to the brain are made visible using imaging techniques such as computer or magnetic resonance imaging. EEG (electroencephalography) can also be performed to rule out epilepsy as a possible cause of amnesia.

Treatment of amnesias

The treatment of amnesia and whether it is possible depends on the cause. If the amnesia is the symptom of an underlying disease, such as epilepsy or migraine, the disease is treated.

Psychological measures can help with mental causes such as psychological trauma. Depending on what the background is, behavioral therapy or deep psychological treatments are possible.

Orientation training is usually part of the therapy of severe memory disorders. In addition, compensation strategies for certain situations are developed, adapted to the everyday challenges of the person concerned. The extent to which therapeutic measures make sense is decided individually depending on the severity and form of amnesia. In particularly severe cases, treatment is often limited to teaching amnesia patients how to best respond to external help.

Can you prevent amnesia?

It is not possible to prevent amnesia. Depending on the form of amnesia, those affected can sometimes do a lot themselves to help their memory jump on the jump. All measures that train the memory are recommended. These can be puzzle games like sudoku, listening to music, exercise or talking to other people.

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