Guide Amnesia And Memory Loss

Introduction

Memory lapse from time to time characterized by occasionally forgetting something and later remembering it is a common occurrence in everyday life. It is also a common and normal occurrence for persons, memory to reduce as they age. Memory lapse or loss becomes a menace when it affects someone’s ability to work, ability to relate to others socially and other cognitive abilities. There are any types of memory disorders whose causes range from the side effects of medications, the use of stimulants such as alcohol and barbiturates(Feren et.al 2011) , mild and severe brain injuries, cardiovascular diseases, strokes and blood pressure problems, vitamin deficiencies, disorders of the endocrine system(Feren et al, 2011) such as thyroid disease among other causes. (Brewer et.al, 2007) Amnesia is a type of memory disorder which is characterized by selective memory impairment in relation to cognitive abilities and preserved intelligence (Talmi et.al, 2015). There are two types of amnesia anterograde amnesia and retrograde amnesia. Retrograde amnesia is when a person has no recollection of information received before the onset of amnesia (Marshman et.al, 2018). Anterograde amnesia is inability to retain new information or occurrences in the recent after the onset of amnesia (Little et.al, 2018)

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With increasing availability of information regarding different diseases on the internet, Patients, care givers and their families are constantly turning to these sources for information to confirm a thing or two. This is because one quickly forgets things learnt one on one interviews with doctors. The danger they face in this respect is access to misleading and incorrect information which may also end up being applied leading to complications in the recovery of a patient. It is therefore essential that these people access correct information. (Brown, 2006) Patients suffering from severe forms of anterograde amnesia also need the support of family, friends and sometimes professional caregivers in order to be able to cope with the disorder. These groups of people need information so that they understand the disease and its implications. The most effective solution to this problem is to have an effectively written leaflet detailing information on the disease to patients and caregivers and their families. Leaflets are effective since they can easily be carried home and used as a future reference. National charities can make use of leaflets to avail information to families and caregivers of patients suffering from anterograde amnesia. This leaflet should be written in simple easy to understand plain language. Avoiding the use of medical jargons as much and possible and in cases where used an explanation be given. (Chiu, 2008) It must also be written in a catchy way to encourage the intended readers and ensure they are interested in reading it. The leaflet is written with the use personal pronouns to ensure the persons feel it is addressed to them. There is the use of diagrams, pictures and illustrations. These diagrams are simple to understand and this banks on the possibility that the patient has seen them before. This is important since a patient suffering from this kind of memory loss has an intact recollection of the past and things learnt at that time. The leaflet is written in a procedural way since patients who suffer from anterograde amnesia are able to remember procedural things than facts. Information is given on the meaning of amnesia and narrowed down to anterograde amnesia, the biological and cognitive aspects of the disease, its causes, its symptoms, its diagnosis, Its prevention, treatment, care involved and the financial implications of the disease. The leaflet is written in question and answer format for most sessions to make it more reader friendly.

It has been noted that in most cases anterograde and retrograde amnesia tend to occur at the same time in one patient. In most cases there is a correlation between the severity of anterograde and retrograde amnesia. It is however possible that anterograde amnesia can occur without the occurrence of retrograde amnesia depending on the extent of injury to the brain or disease. In this exposition anterograde amnesia is discussed. (Smith et.al, 2013)

Anterograde amnesia can be induced by drugs such as benzodiazepines which are powerful amnestic drugs and alcohols which have an intoxicating effect. It can result from an injury of the brain. It can result from the damage of the hippocampus or the medial temporary lobe during a surgical procedure (Staniloiu et.al, 2018) Lack of oxygen, heart attacks and concussions are other possible causes of anterograde amnesia (Cantu, 2001). The human herpes virus-6 (HHV-6) encephalitisas (Maclean & Doueh, 2002) also causes anterograde amnesia. It is however less commonly resultant from emotional disorders such as stress or from shock

This disease results from the disruption of the connections needed for the storage of encoded information in the cortex to form long term memory. For long term memories to be stored the mammillary bodies found in the hypothalamus need to be connected to the thalamus which also needs to be connected to the cortex (Nahum et.al, 2016) Long term memory is in two broad categories declarative memory and non-declarative memory otherwise known as procedural memory. Patients suffering from anterograde amnesia suffer the loss of declarative memory but retain non-declarative memory. The part of declarative memory lost is the episodic part as opposed to the semantic part which remains intact. (Fradera & Kopelman, 2009)

The disease affects a person’s ability to remember current events. That is they may not remember a person they have met just a few minutes ago, they may not remember having performed certain actions for example talking to someone on phone. This disrupts the patient’s work, social and home life. The loss of memory may leave a person with no sense of their progress in life. They are unable to use their experiences to acquire knowledge and understanding. The thinking, attention and language the patients however remain intact.

The key symptom of anterograde amnesia is forgetting occurrences that were in the recent past. A person may forget a person they have just met. They forget information that has been given to them a few hours ago. They however retain memories of things which occurred long time ago. The patients retain their personality, intelligence, judgment, concentration span and identity. They are able to perform procedural things such as riding a bike or singing. They may suffer from disorientation and confusion. People with this disorder are able to be aware that they have.

Factors which increase ones chances of suffering from anterograde amnesia include the excessive consumption of alcohol, suffering from seizures, having suffered a stroke, having undergone surgeries in the brain, being involved in accidents such as road accidents and sustaining head injuries during sporting activities. (Baumer et.al 2017)

Diagnosis of anterograde amnesia is conducted via a series of neuropsychological and neurological examinations. These examinations target a specific inability to learn and retain new information. This is assessed by subsequent poor performance on the memory of the particular new information (Arena et.al, 2015). The tests conducted include; the Mini Mental State Exam which evaluates ones awareness of where they are at that particular time, The Boston Naming Test which accesses one’s vocabulary by requiring them to name objects presented to them as pictures, the index for retrieval of semantic memory in which one is required to name as many animals as possible within a minute. The patient undergoes a test for executive function in which he/she is required to do mental arithmetic. A speeded response test is used to test their ability to withhold responses (Kavanagh et.al, 2017) the revised Wechsler Adult Intelligence Scale is used to determine the full-scale intelligence quotient (IQ) of the patient. The combination of California Verbal Learning Test, Wechsler Memory Scale (WMS), Rey-Osterrieth complex figure recall are used to determine the ability of the patient to recall information that has just been given to them from the range of zero to about 30 minutes. If these tests show a normal full-scale intelligence quotient (IQ) and a low memory quotient that is abnormally low then the person is likely to be suffering from anterograde amnesia

It is always better to prevent a disease than to treat it. This is even more applicable in amnesia cases as there are no cures for the disorder. The baseline of the prevention is to avoid injuries to the brain. This can be achieved by taking safety measures like wearing a helmet when cycling and a seat belt when driving. Any infections should also be treated promptly to avoid a possible spread of the infection to the brain. Immediate medical attention should be sought in the event of a suspected stoke or continuous severe headaches.

There is no curative medication that is currently available for this disorder. For this reason the treatment of anterograde amnesia mainly concentrates on the management of the disorder. One can undergo occupational therapy. This is where one uses their past memories as a basis of creating new ones. Technological devices such as smart phones and tablets can be used to help in day to day tasks (Migo et.al, 2015) This is because smart phones have calendars, camcorders, memos, voice recorders, navigation software’s and web browsers a combination of which potentially offers persons with anterograde amnesia a variety of means to create and even retrieve memory thus allowing them to keep pace with the continuously changing society (Ferguson & Woodberry, 2015). It enables them to be able to almost function as normal. They can be used to remind the person of things that have just happened and this is to facilitate the performance of daily task. With technological advancement it is also possible to have mobile phones and digital voice recorders which contain software customized with the patient in mind. These have been very effective in persons with mild memory loss giving them the ability to function normally. Persons with severe memory impairment can subscribe to text messages which are sent by paging companies at a fee. This reduces greatly the memory requirement on them as they only need to press a button to retrieve the information. This software can be programmed by a doctor or a family member and may require training on the part of the patient to be effective. Other memory aid devices that can also be used are notebooks, calendars and photographs of people they meet and places visited, location maps can be used as a means of accessing recent places that been recently visited (Jamieson et.al, 2017). Anterograde amnesia caused by thiamine deficiency can be prevented using parenteral thiamine when it is at the Wernicke's encephalopathy stage. This is a form of delirium which precedes the amnesia. (Stevens & Rodin, 2011) Anterograde amnesia resulting from the excessive consumption of alcohol or use of drugs can be managed by abstaining from the use of those substances. If the disorder resulted from vitamin deficiencies such as vitamin B12 deficiency then supplements can be used to try to counteract the effects of the disease. There are two training methods that are commonly used in a bid to help people with this disorder to regain their memory. These include the use of the vanishing cues method, where cues are gradually withdrawn until the persons are able to give responses without the cues. The second method is the declarative method which involves the execution of simple tasks for a specified amount of time, then tasks which take longer and longer times are introduced ( Ptak et.al 2010)Research is underway to look for drug interventions for disorders involving the brain function.

Persons living with anterograde amnesia are sometimes very frustrated because of their memory lapses. This frustration often finds its way even to their family members and caregivers. It is therefore important to find a support group of people living with amnesia and their families. The support group may help by providing tips on how to cope with the disorder.

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Conclusion

It is noted from the discussions above that anterograde amnesia takes a toll on one’s life. This is particularly so since this disorder largely affects their ability to function independently because of the losses in memory involved. These patients require the help of their family members, friends and in severe cases of anterograde amnesia advanced care given by caregivers. This is very important as the only means to reverse and alleviate is the use of memory aids which also require assistance of these groups of people. To meet the demand of the hard task of caring for persons with anterograde amnesia sufficient credible information must be provided. This can be achieved through an information leaflet.

References

  • Arena, J. E., & Rabinstein, A. A. (2015, February). Transient global amnesia. In Mayo Clinic Proceedings (Vol. 90, No. 2, pp. 264-272). Elsevier.
  • Baumer, T., Fry, C., Luppe, S., Gunawardena, H., & Sieradzan, K. (2017). Human herpes virus-6 encephalitis causing severe anterograde amnesia associated with rituximab, azathioprine and prednisolone combination therapy for dermatomyositis. Journal of neurovirology, 23(3), 508-510.
  • Brewer, J. B., Gabrieli, J. D. E., Preston, A. R., Vaidya, C. J., & Rosen, A. C. (2007). Chapter 5 - Memory. In C. G. Goetz (Ed.), Textbook of Clinical Neurology (Third Edition) (Third Edition., pp. 63–78). Philadelphia: W.B. Saunders. Retrieved from
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  • Ferguson, S., Friedland, D., & Woodberry, E. (2015). Smartphone technology: gentle reminders of everyday tasks for those with prospective memory difficulties post-brain injury. Brain injury, 29(5), 583-591.
  • Fradera, A., & Kopelman, M. D. (2009). Memory Disorders. In L. R. Squire (Ed.), Encyclopedia of Neuroscience (pp. 751–760). Oxford: Academic Press. Retrieved from
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  • Migo, E. M., Haynes, B. I., Harris, L., Friedner, K., Humphreys, K., & Kopelman, M. D. (2015). mHealth and memory aids: levels of smartphone ownership in patients. Journal of Mental Health, 24(5), 266-270.
  • Nahum, L., Pignat, J. M., Bouzerda-Wahlen, A., Gabriel, D., Liverani, M. C., Lazeyras, F., ... & Zullino, D. F. (2015). Neural correlate of anterograde amnesia in Wernicke–Korsakoff syndrome. Brain topography, 28(5), 760-770.
  • Ptak, R., Van der Linden, M., & Schnider, A. (2010). Cognitive rehabilitation of episodic memory disorders: from theory to practice. Frontiers in human neuroscience, 4, 57.
  • Staniloiu, A., Markowitsch, H. J., & Kordon, A. (2018). Psychological causes of autobiographical amnesia: a study of 28 cases. Neuropsychologia, 110, 134-147.
  • Stevens, L., & Rodin, I. (2011). Syndromes of cognitive impairment. In L. Stevens & I. Rodin (Eds.), Psychiatry (Second Edition) (Second Edition., pp. 70–71). Churchill Livingstone. Retrieved from
  • Talmi, D., Caplan, J. B., Richards, B., & Moscovitch, M. (2015). Long-term recency in anterograde amnesia. PloS one, 10(6), e0124084.
  • Yoshimasu, H., Yasuda, T., & Kurihara, A. (2018). Psychogenic Retrograde and Anterograde Amnesia. Brain and nerve= Shinkei kenkyu no shinpo, 70(7), 803-812.
  • Little, D., Nagele, E., Gallagher, M., & Weston, M. (2018). What Day is Today? A Case of a Patient who Developed Significant Anterograde Amnesia with Abnormal Signal Intensity in the Medial Temporal Lobes on Brain Magnetic Resonance Imaging (MRI) in the Setting of Substance Abuse.(P1. 199).

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