Amnesia Memory Loss

Memory loss is the inability to recall people, objects, places, orevents that took place in the recent or distant past.

What is going on in the body?

The brain stores different types of information in different places. Short-term memory involves recalling details that have been cataloguedseconds or minutes before.Examples include reciting a phone number, recognizing a new face, or repeatinga list of 3 objects seen 2 or 3 minutes earlier. For this to happen,distinct areas deep in the brain need to function properly.

Long-term memory involves the ability to recall events that tookplacein the distant past. For short-term memory to convert to long-term memory,other permanent changes to brain cells have to take place. This is similar tocreating a permanent file or recording. Other parts of the brain perform thisfiling function.

Occasional memory lapses or forgetfulness are common.These may be associated with depression, stress, lack of sleep, and normal aging. Memory loss only becomes aproblem when it is severe and interferes with daily living.

Amnesia is a severe form of memory loss. It may be apartial or complete lack of recall. Depending on the cause of amnesia, thememory loss may arise suddenly or slowly. It also can be temporary orpermanent.

What are the causes and risks of the symptom?

Common medical causes of memory loss include:

normal aging

Alzheimer’s disease, a progressive brain disorder causingdeterioration in memory and thought processes

depression

head injury

seizures

chronic alcoholabuse

barbiturates, hallucinogens, and medications such as those used for anesthesia

electroconvulsive therapy, or ECT, which is used to treat some mentaldisorders

surgery in the temporal lobe of the brain, such as a craniotomy for a brain tumor

lack of oxygen to the brain, such as a near drowning

stroke

Huntington’s disease

atherosclerosis, or hardening of the arteries

multiple sclerosis, a degenerative disorder caused by destructionof the lining of nerves throughout the body

HIV, theimmunodeficiency disorder associated with AIDS

Parkinson’s disease, a degenerative disorder of part of the nervoussystem

Creutzfeldt-Jakob disease, a rapidly progressingdegenerative disorder of the nervous system causing problems with walking,talking, and the senses

Pick’s disease, adisorder ofthe brain that causes slowly progressing dementia

viral or bacterial encephalitis, an inflammation ofthe brain

Lewy body disease, a degenerative disease of the nervous system

normal pressure hydrocephalus, or increasedcerebrospinal fluid in the brain

chronic subdural hematoma, or bleeding between thebrain lining and brain tissue

brain tumor

Wilson disease, a rare disease causing an accumulation of copper in theliver, brain, kidneys, and corneas

neurosyphilis, an infection of the nervous system by the Treponema pallidum\ bacteria. Less often, syphilis is transmitted from a pregnant woman to her baby. This form of syphilis is known as \congenital syphilis.\syphilis bacteria which causesweakness andmental deterioration

Certain abnormalities of a person’s metabolism orhormones may also be responsible for memory loss. These include:

hypothyroidism, which is an underactive thyroid gland

hyperthyroidism, which is an overactive thyroid gland

high-dose steroid abuse

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deficiency of niacin, which is vitaminB3

chronic alcoholabuse

chronic exposure to metals, such as lead or mercury, and to dyes, such as aniline

medication side effects or druginteractions

What other signs and symptoms are associated with this symptom?

Many people with progressive memory loss may not be aware of their worseningforgetfulness. Their family members or friends may be more able to judge whethertheir memory lapses are getting worse. Depending on whether the memory loss involvesshort-term or long-term memory, the individual or family may notice certainevents, such as:

inability to recognize family members

forgetting one’s phone number or home address

forgetting how to return home from a familiar location

forgetting to eat, bathe, or maintain one’s hygiene

forgetting friends’ or family members’ names

How is the symptom diagnosed?

A person does not need to see a healthcare professional about simple memoryloss that happens only once in a while. If memory loss is severe andprogressive, Alzheimer’s disease must be considered. Dementia can be diagnosedonly if a healthcare provider is made aware of the problem.

The family should be able to discuss the range of the person’s symptoms overtime. Included should be how symptoms progressed and whether the symptomsimproved or deteriorated. Also, the family should report how suddenly orgradually symptoms came on. The healthcare provider should also know allmedications that the individual is taking. This includes over-the-counterproducts, herbal remedies,and allprescription medications.

Combinations of drugs may impair memory at times. The healthcare provider willlook for other medical conditions that may contribute to the symptoms.

To determine if other medical conditions are contributing to the symptoms,tests may be done. Tests may include:

blood tests, such as a complete blood count, or CBC, thyroid function tests,tests forinfectious diseases and vitamin levels in the blood

memory testing

electroencephalogram, or EEG, which measures brain waves

electrocardiogram, or ECG, whichmeasures the electrical activity of the heart

cranial MRI orcranial CT scans, which look at thestructures of the brain

spinal tap, aprocedure inwhich a small amount of fluid is withdrawn from the spinal column to look forinfection or bleeding

What can be done to prevent the symptom?

Mild memory loss comes normally with aging. Keeping the brain active may helpto preserve brain cells. Reading, singing, doing puzzles, conversing,exercising, and eating a balanced diet stimulate blood flow and activity in thebrain.

Many cases of memory loss are due to Alzheimer’sdisease. Although there are no proven methods to preventAlzheimer’s disease, recent research findings provide some options that mayslow the onset of the disease or the progression of symptoms. These findings,which need further study, include:

low doses of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs),which may work by making blood cells and vessels less sticky and improvingblood flow

actively engaging in cognitive activities such as reading, which mayincrease the nerve connections in the brain and delay the onset of thedisease

taking antioxidants such as VitaminE and selignine. In the Alzheimer’s Disease Cooperative Study, adose of1,000 IU of Vitamin E and 5 mg of selignine twice daily delayed nursing homeplacement, loss of the ability to perform self-care, and severe dementia.

hormone replacementtherapy formenopausal women, whichmay delay theonset of symptoms of Alzheimer’s disease. The relationship between the hormoneestrogen and Alzheimer’sdisease stillneeds further investigation.

avoiding head injuries. A person should wear a seat belt at all times whenriding in a motor vehicle. Sports safety guidelines for children, adolescents, and adults can behelpful in avoiding other head injuries.

Strokes are another major cause of memory loss. Preventing or treatinghigh blood pressure, obesity, diabetes, high cholesterol, and alcohol abuse can lower the risk ofstroke.

What are the long-term effects of the symptom?

Occasional memory lapses do not usually disrupt daily life. However, individuals withlong-term, progressive dementia will continue to lose mental abilities.Ultimately, this makes independent living impossible. A person suffering fromthe condition often requires nursing home care. The family may faceconsiderable financial expense in caring for the person. Extensive medical caredue to falls, trauma, infections, and depression may also result.

What are the risks to others?

Memory loss is not contagious and poses no risk to others. If the memory lossis caused by an infection such as AIDS, the infection may becontagious.

What are the treatments for the symptom?

There are several steps a person can take to improve his or her memory. Theseinclude:

following a regular routine when possible

setting up a reminder system. This may include a book, calendar, orpocket diary.

making daily lists

keeping track of daily medications. This can be done with a medicationreminder box or a chart posted on the refrigerator.

keeping track of appointments, birthdays, and bills to pay

keeping a list of names and telephone numbers

keeping keys in the same place

The 3 medications currently approved by the Food and Drug Administration fortreatment of Alzheimer’s disease are donepezil, tacrine, and rivastigmine.These medications are designed to improve memory by increasing the amount ofacetylcholine in the body.

Other medications, such as risperidone or quetiapine, may also be used to helpbehavioral problems such as hallucinations, delusions, or agitation. Someindividuals with memory loss may also need medications for depression, anxiety, or insomnia.

Other treatments include support and education for those caring for people withmemory loss. Individual and family counseling can be beneficial. It’s also been found that support groupsassist caregivers. As the memory loss progresses, manyfamilies are unable to care for the person at home, and placement in a specialfacility becomes necessary.

What are the side effects of the treatments?

Medications used to treat memory loss can damage the liver, soperiodic liver functiontests areneeded. Other side effects may include nausea, diarrhea, insomnia, vomiting, fatigue, or muscle cramps.

What happens after treatment for the symptom?

In most cases, memory loss is a degenerative condition without acure. Treatment is lifelong. Because the course of memory loss isunpredictable, individuals with the condition should make plans for end-of-lifecare while they are still able to participate in the decision-making process.

Difficult issues that family members may face include:

promoting independence while making sure the individual is safe

removing driving privileges

finding supportive care among family or in an assisted living facility ornursing home

making business decisions

determining executors of written wills and making sure advanceddirectives are in the individual’s patient file at his or her doctor’soffice

How is the symptom monitored?

Individuals with memory loss will have periodic visits to thehealthcare provider for evaluation and treatment. Periodic liver function tests may be ordered if the personistaking one of the medications that can cause liver damage. Any new or worseningsymptoms should be reported to the healthcare provider.