What is amnesia (amnesiac syndrome)?

Amnesia is a dramatic form of memory loss. If you have amnesia you may be unable to recall past information (retrograde amnesia) and/or hold onto new information (anterograde amnesia). Amnesia, in the Greek language, means “forgetfulness.” However, amnesia is far more complicated and severe than everyday forgetfulness. Forgetting what your spouse asked you to pick up at the grocery store is “normal.” Forgetting that you are married can be a sign of amnesia.

Amnesia is often portrayed in movies and TV shows. What soap opera hasn’t had a storyline involving it? Fictional characters with amnesia often lose their entire identities. They can’t even remember their names. Fortunately, amnesia usually isn’t that severe in real life.

How does memory work?

Memory is the ability to hold onto (retain) and recall information from the past. There are three stages of memory: encoding, storage and retrieval.

• Encoding: The brain receives new information and creates a series of connections to represent that information. Those connections may link to other information already stored in your memory. For many types of information, you have to be paying attention to accurately encode the information.
• Storage: Those previously formed connections are maintained in your brain, even though you may not be using them.
• Retrieval: The brain recreates or activates the connections that represent previously encoded information and you can recall or recognize that information from the past.

This is a simple description of how memory works. Keep in mind that these stages and the processes within them are imperfect. Memory itself is imperfect. The witness to a robbery might remember a blue shirt when the robber was actually wearing green. Such forgetfulness is just that — forgetfulness — not necessarily a sign of amnesia.

There are several types of memory. Here are the two most relevant to understanding amnesia:

1. Declarative/Explicit: Knowledge of facts and events in everyday life. Amnesia can erase these memories.
2. Nondeclarative/Implicit: Non-conscious knowledge. Amnesia will not erase these “ingrained” memories. If you have amnesia, you should still remember how to walk or ride a bike.

The brain areas involved in memory are different depending on the type of memory you are forming and how long it can be stored.

• Short-term memory: Your short-term memory lasts as long as you have the information ‘in mind’ – usually between five seconds and 30 seconds. During that time you’re able to juggle an average of seven pieces of information – for example, seven letters, seven words or seven numbers. The frontal and parietal lobes are important for this type of memory.
• Long-term memory: Your long-term memory lasts between a minute and a lifetime. In theory, there’s no limit to your long-term memory. However, there is a limit to your ability to recall that information. The hippocampus and surrounding temporal lobes of the brain are important areas for long term storage and retrieval of information. However, long-term memory involves many areas of the brain and damage to many different parts of the brain can cause amnesia.

How common is amnesia? Who gets it?

Amnesia can occur in many common neurological disorders like Alzheimer’s disease and other forms of dementia, stroke and traumatic brain injury, as well as other systemic illnesses that affect the brain.

Are there different types of amnesia?

There are many different names for amnesia and amnesia syndromes. Here are a few common terms you may encounter:

• Retrograde Amnesia: Describes amnesia where you can’t recall memories that were formed before the event that caused the amnesia. It usually affects recently stored past memories, not memories from years ago.
• Anterograde Amnesia: Describes amnesia where you can’t form new memories after the event that caused the amnesia. Anterograde amnesia is far more common than retrograde.
• Post-traumatic Amnesia: This is amnesia that occurs immediately after a significant head injury. It may involve retrograde amnesia, anterograde amnesia, or both.
• Transient Global Amnesia: A temporary syndrome where you experience both retrograde and anterograde amnesia. Memory loss is sudden and only lasts up to 24 hours.
• Infantile Amnesia: This is the term used to describe the fact that people can’t recall memories of events from early childhood. Few people have memories from before the ages of three to five because the brain areas that support memory are still developing.
• Dissociative Amnesia/Psychogenic Amnesia: A mental health disorder where you experience amnesia after a significant trauma. You block out both personal information and the traumatic incident from your memory.

Is amnesia real?

Yes, but it is rarely as it is portrayed in movies and TV shows. Typical patients don’t lose their entire identities.

What causes amnesia?

Amnesia causes are divided into two categories: neurological and functional. Here are some of the most common causes.

Neurological Amnesia.

Brain injuries:

• Trauma from a car crash, sports, a fall from a ladder, penetrating object (i.e.,bullet), etc.

Brain diseases:

• Alzheimer’s disease and other dementias.
• Stroke.
• Seizure.
• Brain tumor.

Brain infections:

• Encephalitis.
• Lyme disease.
• Syphilis.
• HIV/AIDS.

Other:

• Anoxia (lack of oxygen).
• Cardiac arrest.
• Thyroid issues.
• Alcohol use disorder.
• Vitamin B1 (thiamine) or B12 (cyanocobalamin) deficiency.
• Radiation.
• High levels of corticosteroids.

Functional/Psychogenic/Dissociative Amnesia.

Functional amnesia, a psychiatric disorder, is rarer than neurological amnesia. It is not associated with any known brain trauma or disease but rather appears to occur because of an emotional trauma. This is usually retrograde amnesia (inability to remember past information). Occasionally, it is so severe that the person may forget their own identity.

Does amnesia erase the person’s identity?

Only in very rare, very severe cases of functional amnesia.

How long does amnesia last? Is amnesia permanent?

Amnesia can be:

• Temporary, such as after a head injury as your brain heals.
• Permanent and unchanging, such as after a serious disease like encephalitis or a stroke.
• Progressive or slowly getting worse, such as from progressive diseases like dementia.

Are amnesia and Alzheimer’s/dementia the same?

They are not the same. Amnesia is a symptom while dementia is a disease. Think of this like the relationship between a fever (the symptom) and the flu (the illness). Alzheimer’s is one type of dementia.

Is Mild Cognitive Impairment (MCI) the same as amnesia?

No, MCI is not amnesia. MCI is a diagnosis that means that there has been a slight decline of memory or other thinking skills that does not interfere with daily life. Some 15% to 20% of adults ages 65 and over have MCI.

Do patients with amnesia lose their motor skills?

Motor skills are nondeclarative. People with amnesia don’t lose learned motor skills – skills that require coordinated movement of muscles. “Just like riding a bike” is an old saying that means the learned activity is “second nature” — easy to remember and repeat. In fact, studies by neurologists have proven that people with amnesia learn motor skills at the same rate as healthy individuals.

Does amnesia change the patient’s personality?

No. Personality change may happen when the areas of the brain that control personality and behavior are also damaged.

Do people who have amnesia have a shorter attention span?

No. They’re forgetful, but that doesn’t mean they’re not paying attention to the extent that they did before the event that caused the amnesia.

Is amnesia common when a person is drinking alcohol?

Alcohol can stunt the brain from developing new memories. Two types of memory events can happen to people with alcohol use disorder: blackouts and amnesia.

People with alcohol use disorder who have poor diets are at risk of developing Wernicke-Korsakoff syndrome. Wernicke-Korsakoff syndrome (alcohol-related amnesia) affects 1% to 3% of the population, often people who are between 30 years old and 70 years old. Researchers have concluded that alcohol prevents the body from processing the nutrient B1, a vitamin vital to memory. The damage done to the brain by alcohol-related amnesia is permanent in 80% of cases. This alcohol-induced syndrome includes a severe anterograde amnesia or the ability to form new memories. Patients may also confabulate or ‘make up’ highly unusual memories.

How is amnesia diagnosed?

Your healthcare provider may assess your memory through talking with you and observing how well you encode information they give you or how well you can recall past information. They may consult with people who know you to find out how your memory works in daily life. They may also refer you for formal memory testing, called a Neuropsychological evaluation.

To determine the cause of amnesia, your provider may order blood tests to check vitamin B1 levels, B12 levels and thyroid hormones. They may order imaging tests, such as an MRI (Magnetic Resonance Imaging) or computed tomography (CT) scan to look for signs of brain damage, such as brain tumors or stroke. An EEG (electroencephalogram) may be ordered to check for seizure activity. A spinal tap may be ordered to check for brain infections as a cause of the memory loss.

How is amnesia treated?

There is no pill that can cure amnesia. However, amnesia can improve as the brain heals in some conditions. When memory loss is persistent, there are skills you can learn to compensate.

Cognitive rehabilitation involves teaching new skills to patients with anterograde amnesia. These might include organizational strategies (e.g., a daily white board where the date, appointments, or other important information can be easily accessed) or compensatory technology (i.e., cell phone alarms and reminders for routine tasks like medications). Success varies. Occupational therapists often perform cognitive rehabilitation. Occupational therapists also help your family and friends cope with their role as caregivers.

What medications treat amnesia?

There is no drug treatment for amnesia — yet. Some researchers are experimenting with medications typically given to Alzheimer’s patients, but the FDA (the U.S. Food and Drug Administration) has yet to approve those drugs for amnesia.

How can I reduce my risk of amnesia?

You can reduce your risk of the symptoms by reducing your risk for related diseases. Always wear protective equipment like a seat belt when you’re in a vehicle, a helmet when you’re bicycling and playing sports, and sturdy shoes to keep yourself from falling, etc. Research suggests that you can reduce your risk of developing diseases like Alzheimer’s with lifestyle choices:

• Exercising. Cardiovascular exercise and strength training may be beneficial.
• Eating a healthy, balanced diet. The Mediterranean diet is highly recommended.
• Staying mentally active. Take a class and break out the crossword puzzles.
• Getting plenty of sleep. Treat your insomnia and sleep apnea.
• Stopping smoking. There’s evidence that shows that smoking increases your risk of cognitive decline.
• Staying in touch with loved ones. Your social well-being is important just like your physical well-being.
• Managing stress. Get treatment if you have symptoms of depression and anxiety.
• Protecting your heart by losing weight, lowering your blood pressure and managing your diabetes.

What can I expect if I have amnesia?

Amnesia can last hours, days, months or even longer. Your individual outcome is best predicted by your healthcare provider who has examined you and determined the cause and the severity of your amnesia. People with amnesia generally have to rely on family and friends to fill in the gaps in their memory and function in daily life.

When should I see my healthcare provider about memory loss?

Contact your healthcare provider if you’re having issues with memory loss. Memory loss can be a sign of a serious condition such as Alzheimer’s disease.

What questions should I ask my healthcare provider?

• Is my memory loss normal for my age?
• What is causing my memory loss?
• Are there any medications that can help with the disorder causing my loss?
• Will my memory get better or worse over time?
• How can my family and friends help me?
• Are there therapies or cognitive rehabilitation that would be appropriate for my memory loss?
• Can you recommend mental health resources like a psychiatrist and therapist (if needed)?