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Acute-onset amnesia: transient global amnesia and other causes
  1. Thomas D Miller1,2,
  2. Christopher R Butler3
  1. 1 Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
  2. 2 National Hospital for Neurology and Neurosurgery, London, UK
  3. 3 Department of Brain Sciences, Imperial College London, London, UK
  1. Correspondence to Dr Thomas D Miller, Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, UCL, London, London, UK; t.d.miller{at}


Acute-onset amnesia is a dramatic neurological presentation that can cause considerable concern to both patient and clinician. The patient typically presents with an inability not only to retain new memories but also to access previously acquired memories, suggesting disturbance of hippocampal function. Transient global amnesia (TGA) is the most common cause of acute-onset amnesia, and is characterised by a profound anterograde and retrograde amnesia that typically lasts for up to 24 hours. Although TGA has a strikingly stereotypical presentation, it can be challenging to distinguish from other causes of acute-onset amnesia, including posterior circulation strokes, transient epileptic amnesia, psychogenic amnesia, post-traumatic amnesia, and toxic/drug-related amnesia. Here, we describe the general approach to the patient with acute amnesia; summarise the clinical and neuropsychological differences between the potential causes; and, provide practical recommendations to aid diagnosis and management of acute amnesia. Regardless of cause and the dramatic presentation, non-ischaemic acute-onset amnesia generally has a favourable prognosis.

  • amnesia
  • stroke
  • epilepsy
  • cognitive neuropsychology
  • MRI

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  • Contributors The manuscript was desgined by TM and CB. The authors contributed to drafting and revision of the manuscript for intellectual content.

  • Funding TDM is supported by the Wellcome Trust (2229/Z/21/Z).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed by Adam Zeman, Exeter, UK, and John Baker, Truro, UK.

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  • Editors’ commentary
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