Transient Global Amnesia and its treatmet/medication

Posted by kyoto @kyoto, Feb 12, 2019

Hello,
As I have written elsewhere on this site, I was treated surgically for a large, subarachnoid cyst (in the velum interpositum) in the summer of 2017. I had been experiencing severe amnesia. The operation was successful in that my memory improved. The surgeon warned of the risk of "convulsions" in the surgical plan, and over the following year or more, I had ongoing occurrences of memory loss. Last December, my surgeon started me on epilepsy medication, as a treatment for these memory failures. From my reading, I took it that I had Transient Epileptic Amnesia. Today, I went for my latest check-up and to get my next prescription of epilepsy (Vimpat aka Lacosamide), and he told me that in fact I have Transient Global Amnesia. (TGA)
So far so good, but I immediately checked the medical literature on TGA, and the first paper I read (published in QJM) says that TGA doesn't respond to anti-epilepsy drugs. https://academic.oup.com/qjmed/article/107/11/915/1512956
I thought Lacosamide is an anti-epilepsy drug. If TGA doesn't respond to it, why has the doc prescribed it? Vimpat is a non-generic drug and it's really expensive.
Does anyone have a similar situation or knowledge about TGA or its treatment?
Many thanks,
David

Liked by Leonard

Hi, @kyoto – experiencing severe amnesia would be very hard, and I'm sure, quite disconcerting.

I'd like to bring in some other members who've talked about transient global amnesia (TGA), like @debera @sybilla @marienancy @sheshe @bernese53 @lorispellman @cjc56 @ceil for their input on how TGA has gone for them and any thoughts they may have about treatment with lacosamide. @jakedduck1 @johnbishop and @jenniferhunter may also have some insights.

I'd also like to offer some Mayo Clinic information on this medication https://www.mayoclinic.org/drugs-supplements/lacosamide-oral-route/description/drg-20072409

Have you had the opportunity to ask your doctor or the pharmacist about the prescription of lacosamide, since you sound uncertain about it? If so, what did they say?

Liked by kyoto

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Hello David @kyoto, I know it can be hard searching for answers on the Internet. I did a search on Google Scholar (https://scholar.google.com/) for transient global amnesia treatment and it found quite a bit of information. Here is a link to the search results:
https://scholar.google.com/scholar?as_sdt=0,24&q=transient+global+amnesia+treatment&hl=en&as_ylo=2019
John

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@lisalucier

Hi, @kyoto – experiencing severe amnesia would be very hard, and I'm sure, quite disconcerting.

I'd like to bring in some other members who've talked about transient global amnesia (TGA), like @debera @sybilla @marienancy @sheshe @bernese53 @lorispellman @cjc56 @ceil for their input on how TGA has gone for them and any thoughts they may have about treatment with lacosamide. @jakedduck1 @johnbishop and @jenniferhunter may also have some insights.

I'd also like to offer some Mayo Clinic information on this medication https://www.mayoclinic.org/drugs-supplements/lacosamide-oral-route/description/drg-20072409

Have you had the opportunity to ask your doctor or the pharmacist about the prescription of lacosamide, since you sound uncertain about it? If so, what did they say?

Jump to this post

Thank you, Lisa. And let me add what a great, great resource this website is. Incredible, actually with all the moderators and information available. And thank you for answering me so quickly.
My doc is great, but he seems very cautious in saying very clearly one way or the other about various issues. I can say that my memory feels a lot sharper since being on Lacosamide. It's just this apparently reputable journal article clearly said TGA doesn't respond to epilepsy medication, so I wonder what I am being treated for.

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@johnbishop

Hello David @kyoto, I know it can be hard searching for answers on the Internet. I did a search on Google Scholar (https://scholar.google.com/) for transient global amnesia treatment and it found quite a bit of information. Here is a link to the search results:
https://scholar.google.com/scholar?as_sdt=0,24&q=transient+global+amnesia+treatment&hl=en&as_ylo=2019
John

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Thank you, John. I will next look at these articles.
As I said to Lisa, Mayo Clinic is such a wonderful site, and I really thank you all for your kindness and dedication.
David

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@kyoto

Thank you, Lisa. And let me add what a great, great resource this website is. Incredible, actually with all the moderators and information available. And thank you for answering me so quickly.
My doc is great, but he seems very cautious in saying very clearly one way or the other about various issues. I can say that my memory feels a lot sharper since being on Lacosamide. It's just this apparently reputable journal article clearly said TGA doesn't respond to epilepsy medication, so I wonder what I am being treated for.

Jump to this post

@kyoto
Hello,
I can’t really speak to Trans Global Amnesia (TGA) or subarachnoid cyst as I’m more familiar with Retrograde and Anterograde Amnesia as related to Epilepsy. I’m quite confident your doctor isn’t giving you an Anticonvulsant to improve your memory. Anticonvulsants are notorious for causing memory problems. As to why he ordered it, maybe to help prevent seizures which could cause additional memory issues because of your surgery. When were you given Vimpat?Were you ever on any other seizure medication? Have you ever had a seizure of any type before or after the surgery?
On a more positive note, TGA seldom lasts more than a matter of hours. In fact, you usually regain some if not all your memory except those memories that might have been made during the time that caused the loss in the first place. Can you be more specific as to what your memory problems are? Do you forget things but remember them at a later time or are days, weeks, months or years gone.
Health & Happiness,
Jake

Liked by Lisa Lucier, kyoto

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Hello Leonard, I really appreciate you taking the time to think about this and write to me. You ask good questions. I don't have answers to them all, and I wish my doctor, good though he is, were more informative.

The story is that I had a large cyst in a part of the brain adjacent to the memory part in a ventricle. (https://en.wikipedia.org/wiki/Choroid_plexus. It brought headaches and memory loss. I never lost awareness of who I am, or faces, etc. but episodes of my experience would just disappear, such as having been on an overseas business trip with a colleague, promises made and before completely vanishing. Part of the diagnosis was WAIS testing, my score for working memory was very low. MRI showed a huge inflated cyst right in the middle of my brain.

I had the surgery, and the cyst was removed, and within days the WAIS test score was above average. But then over the following year, similar (I don't know if it was the same reason) amnesia would occur. Eventually, my surgeon said it was probable that I was having brain-only epilepsy. I have never had a full-body seizure or lost consciousness. A couple of months back he started me on Valpro, but I had a physical reaction against it, and then he switched me to Vimpat (Lucosamide). I have felt cognitively sharper on it over the last month.

I am 50 now, but I have never been suspected of having epilepsy previously. My understanding is that the cyst may have somehow affected the circulation of blood, and that vascular insufficiency could have brought on this epilepsy. The acute problem with the cyst happened about two years ago, but as time goes by, it is obvious that certain memories that should be there are gone, or at least inaccessible. The furthest back I have identified such missing memories is about six years ago. So my thought is that I may have had this form of epilepsy for a long time. What I don't know is whether the subarachnoid cyst exacerbated this existing condition or actually is the cause of it, due to disrupted blood flow.

Do people go through life with mild undiagnosed epilepsy and are just thought to be a bit absent-minded?

Anyway, from my reading, I thought I had TEA, but the doctor yesterday said TGA. Do you know if TGA responds well to anti-epilepsy medication?

I would really appreciate your insight! Your profile shows that you must know an awful lot about this.

Best,
David

Liked by Leonard

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@kyoto
Hello,
Ask your doctor directly why he prescribed this medication, make him be very specific. Have you ever had an EEG?
Health & Happiness,
Jake

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@jakedduck1

@kyoto
Hello,
Ask your doctor directly why he prescribed this medication, make him be very specific. Have you ever had an EEG?
Health & Happiness,
Jake

Jump to this post

Yes, I had an EEG. That is for epilepsy testing. Is that right? I remember the doctor was slightly cautious, not saying that this was a classic read out for epilepsy. But he seems satisfied that this is what I have.
You are right. I should make him be very specific.

Liked by Leonard

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