LAUSR

Background Transient global amnesia (TGA) is a syndrome that has been known to occur predominantly within the adult population. It’s an entity characterised by sudden loss of memory with confusion that lasts less than 24 hours. The event itself is never associated with focal neurological findings and the patient remains conscious throughout the event. Some of the precipitants documented within the literature have included swimming, immersion in cold water, extreme physical exertion or emotional stress. There has been much debate to date over the etiology/pathogenesis of TGA, including migraine, epilepsy, emboli, ischaemia of hippocampal regions or even venous congestion have all been suggested causes. While TGA is more prevalent amongst those >60 years of age, there has been very few instances of TGA in childhood. Aim To describe a case of transient global amnesia in a teenage boy. Methods We report the clinical presentation, results of investigations and outcome to date in a fourteen year old boy who presented in an acute confusional state, the ultimate cause for which was transient global amnesia. Results A 14 year old boy presented to the Paediatric Emergency Department (PED) for evaluation of acute confusion following a hurling match. A previously well, neurodevelopmentally appropriate child, he had no significant family history nor did he have any regular medications or allergies. Being an active sportsman, he had just participated in an intense hurling match that had lasted almost two hours in exceptionally cold weather. On cessation of the game, he had approached his coach disoriented and claiming ‘I do not know where I am or why I am here’. He continued to ask bizarre repetitive questions, and had no memory of the match for the following 12 hours. His neurological exam was normal, with no loss of consciousness or head injury. Basic blood work, toxicology screen, CXR and ECG were normal. Twenty fours later he had completely recovered. CT brain, MR brain with angiography and EEG were normal. At follow-up six weeks later, he had remained perfectly well with normal neurological assessment. Conclusion Childhood transient global amnesia is rare. Recurrence has been reported in those with a history of recurrent migraine. Our case is interesting in that it deviates from such reports whereby this episode seems solely provoked by Valsalva-like activity (extreme exertion)