Tuesday, February 05, 2013

Memento, TGA, & Ocracoke

Some time ago I watched the video, Memento, a complex, often confusing movie that was rewarding, but hard work to watch. This was my second time watching Memento, and I have to admit it made a lot more sense the second time. One more time would help, too! At least two things make it a difficult movie to watch. It proceeds backwards in time, in a series of relatively short segments...and the main character (with whom the viewer identifies) has lost his recent short term memory, so it's a challenge to follow the action and make sense of what is going on.

The first reason I mention this movie (and the main reason I chose to watch it a second time) is that I have had a series of TGA (Transient Global Amnesia) episodes. Although not as severe as the disorder portrayed in the movie, and very short-lived (TGA typically lasts only about 4-5 hours), the symptoms are otherwise quite similar.

During a typical TGA episode I am unable to recall recent, mostly new information (names, numbers, dates...during my last encounter I had no idea what year it was, though I knew it was sometime in the 2000s), but am totally connected to who I am, where I live, etc. and have no trouble functioning (talking on the telephone, making decisions, etc.). Still, I can't remember certain details afterwards, and I repeat questions and comments over and over again (like an Alzheimer's patient) because I can't remember that I already said the same thing just moments ago.

Happily, this disorder generally manifests only once (although sometimes more often -- I have had it about six times), doesn't seem to be connected to any other physical or mental disorders, and as far as I know, is not predictive of any future cognitive problems.

The second reason I mention TGA is that I know of two other people on Ocracoke who have had TGA. My understanding is that it is an uncommon disorder. Information on the Internet suggests that the worldwide incidence of TGA is between 3 & 30 for every 100,000 people. The first doctor I consulted had no idea what was going on. But it seems strange to me that at least three people in this small community of about 950 people have had at least one TGA episode. There may be more, of course. But still, that's somewhere between 10 and 100 times the worldwide average. I'm wondering if the statistics for Ocracoke really are unusual. If you've had it, do you know of other family members or friends who have had it? Just curious.

Our latest Ocracoke Newsletter is the story of windmills on Ocracoke. You can read it here: http://www.villagecraftsmen.com/news012113.htm.

20 comments:

  1. Anonymous8:21 AM

    Yes we all know we have to get the new info into the short term memory banks then into the long term memory banks -- for me concentrating on what I am doing -- did I turn the coffee maker off? did I lock the front door? requires me as I am doing the task -not in an absentminded way but a mind full way - I make a mental note as I engage in the task to help bump it into the instant recall arena perhaps this will help or allow for further approaches

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    1. What you are speaking of is much different from TGA. During an attack of TGA I would instantly forget new information...over and over again. For example, if I looked at a name written on a piece of paper, then immediately covered the name, I could not recall it. I could do this repeatedly with the same name. I asked my daughter over and over what year it was, then forgot it as soon as I was told. TGA lasts about 4-5 hours, then memory returns to normal.

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  2. Anonymous9:50 AM

    I'd be worried it wasn't a mini stroke.

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    1. TGA is not a mini stroke. And it seems that an incidence of TGA is not a predictor of stroke. It also doesn't seem to have any connection with Alzheimer's or any other cognitive abnormality. The worst effect is the feeling of anxiety during an attack...because you know you can't remember stuff!

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  3. Anonymous10:35 AM

    Hmm now what part of our brain is the short term memory ? if info isn't being processed to the short term memory .... I know this probably isn't helpful but do you try to associate new info with something you already know for example the name Tim jones makes me think of Tom Jones the singer -- it's not unusual... and then well its word association just on an everyday thing to remember and to build new synaps synapsis connections sumpin' like that

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    1. With TGA new information (not all new information, just some) is lost instantly. Associations won't help because as soon as the new information is removed it is lost. For example, you can look at a name over and over (and try to make associations, but they are lost instantly), and when the name is covered over it is gone from memory. It is typical to repeat the same questions repeatedly (e.g. "Did I tell you.....?" "Yes you did, at least six times in the last couple of minutes." "Did I tell you.....?" "Yes you did at least seven times in the last few minutes.", etc. etc.) TGA is not normal forgetfulness (Now, where did I leave my keys? or Did I already brush my teeth?) TGA is a very interesting phenomenon.

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  4. Bear MacDonald10:38 AM

    The tips that Anon 8:21 offers will be helpful to someone like myself. I do not suffer from TGA. My short term memory dysfunction is related to daily activities of living that require no cognative effort. Did I apply deoderant under both arms? (The truth shall become self-evident later in the day.) However I have discovered that I have left a burner on or the water running in the bathroom, once causing water cascading into the basement. I'd like to believe that my house is haunted by a prankster, but alas, I'm a product of my generation and have blown out more brain cells than most folks are capable of utilizing.

    I once suffered a severe case of Vertigo that required hospitalization. it was diagnosed as Vestibular Neuronitis which would run it's course with decreasing severity and fade away, which it did.

    I don't know a d*** thing about TGA other than what you just wrote. If it is viral in origin like my multiple episodes of vertigo, then it may run it's course and go away.
    I hope so and wish you good luck.

    Take care,

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    1. Bear, I don't think TGA is viral...and once it is understood, it doesn't cause much anxiety. Actually, it has become quite entertaining to family and close friends.

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  5. Anonymous12:07 PM

    Don't laugh studies have show that walking through a door way makes people forget things honestly-- walking through a doorway! How many times have I asked myself why? now why did I come into the bedroom ? oh I see to finish making the bed

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  6. Anonymous4:53 PM

    Philip, it seems you're fairly comfortable in your understanding of TGA, at least as it pertains to you. "I know what it is. I've had medical consultation. It's not lasting, progressive, or an indicator of anything more serious." It's a "condition" that (happily, as these things go) seems to have lapsed into the category of party novelty. My wife is a psych/mental health nurse practitioner with long experience in the field, but I've never heard her mention TGA. I'm curious to know if she has any insights.

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  7. Using the 30 out of 100,000 incidence rate for TGA and an Ocracoke population of 948 from 2010 US Census, the probability of one person having it would be .0003 (rounded). The odds of three people having it (assuming no genetic component) would be .000000000027. I always knew you islanders were an unusual group.

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  8. Anonymous5:49 PM

    Heaven forbid. You may have to learn the match game all over again.

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  9. Anonymous8:59 AM

    Philip, Not to cast aspersions on your healthcare provider, but...my wife the psych NP had an interesting take on the situation you described re. the out-of-proportion prevalence of TGA diagnoses on Ocracoke: Perhaps the same PCP has "misdiagnosed" all three cases.

    Granted, this was after all of five minute's worth of consideration re. the matter, and with no further clinical analysis than my recitation of your post, but...she said she's "heard" of TGA, she recalls from her days as a "baby nurse" that it used to be called psychotic fugue about 30 years ago, and that it's apparently quite rare. Her knee-jerk thought was that the symptoms sound more akin to TIAs, transient ischemic attacks (mini strokes).

    Again--not to cast aspersions, but...just one more log on the fire for conversation's sake.

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    1. Thank you for this observation. You are not the only person to suggest TIAs, but our conditions fit classic TGA symptoms. All of the doctors and other health care providers reached the same conclusion -- TGA. I have read quite a lot about TGA myself. I have no doubt about the diagnosis. I am sure my attack was not a TIA.

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    2. Anonymous8:55 AM

      A subsequent review of the wikipedia entry for TGA suggests possible correlation to migraines. This reminded me of opthalmic migraine, a painless, infrequent, short-lasting, and apparently benign condition I've experienced several times during which the field of vision in one eye is vaguely blurred by a jagged line rather in the form of a picket fence.

      As you suggest re. TGA (as these sorts of things go), not a bad "episode" to have to endure, once you know what it is. There's a brief sensation that it's about to occur, the episode isn't particularly debilitating, and it's over in about 40 minutes.

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  10. debbie s.8:17 PM

    I was thinking the same as Anon 8:59. For being so rare, it seems to be awfully common on the island. One of those 'possible but not probable' scenarios maybe? i dunno...

    My grandma has dementia and as you (maybe, lol) remember, Toshio had a stroke almost 2 years ago but other than some occasional random memory loss, it didn't affect his memory much

    take care and have amy record you it could provide a few laughs LOL

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    1. Please see my reply above re. TGA & TIA. All three of us on Ocracoke are doing fine. Thanks for asking.

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  11. Anonymous6:46 AM

    Perhaps it's God punishing you for giving knives to little children!

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  12. Hi, Hope you are doing well. I've thought about this blog for a while and am wondering if you or the other two persons exhibiting TGA are on statins? This drug is highly pushed by the medical community and has some side effects that are not publicized. If you are on a stating, have a conversation with your health care professional about it. Please don't take offense to my question as I am just a naturally curious person and a retired pharmacist. I have seen trends in medicines and try to keep an open mind. Good luck and keep on writing. I love your blog

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    1. Thanks for the comment. No, I am not on statins. In fact, I do not take any medications at all. Though at 68 meds are probably in my future!

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