TGA Checklist

RISK FACTORS:

  • Past history of TGA
  • Advanced Age
  • Migraneous Headaches

EXAMINATION:

  1. full neuro exam (CN, sensory, motor, cerebellu, reflexes)
  2. memory exam (explicit memory loss, intact implicit memories)
  3. test immediate (intact) vs delayed recall (impaired)
  4. test attention span with serial 7’s WORLD backwards (intact)
  5. test procedural memory (intact)
  6. MMSE

TGA – all symptoms should resolve under 24 hours.

DIAGNOSTICS:

  1. if no resolution in 24 hours – requires broader investigation (MRI/CT, LP, EEG)
  2. imaging:  MRI preferred over CT unless suspicion of acute ischemic stroke
  3. EEG to r/o seizures
  4. work-up patients with no witness at onset, <50 years old (rarer), high risk (immunocompromised, drug / ETOH use, abnormal VS)

TREATMENT:

  1. thiamine if h/o ETOH abuse
  2. hold meds that can cause amnesia (benzos)
  3. observe in ED OBS UNIT or inpatient x 1-2 days until resolution of symptoms
  4. serial neuro exams until patient returns to normal

 

REFERENCE:  http://emdidactic.blogspot.com/2017/04/transient-global-amnesia.html

Published by heustein

Leave a comment