MEMORY PUZZLE

Transient Global Amnesia is a frightening and mysterious neurological phenomenon that most of us have never heard of.

Transient Global Amnesia is a frightening and mysterious neurological phenomenon that most have never heard of.

When Paul Rupil started to notice some gaps in his memory, his first instinct was that he must be in the midst of a stroke. It had been a long day; a four-hour drive back home after a family holiday, then unpacking the car, re-assembling his daughters’ bikes and preparing to go back to work.

The first sign that something was wrong was a visual aura, usually the first sign of a migraine. Paul told his wife, Natalie, he was feeling unwell, but he carried on with the evening, sitting down for a family dinner, and then reading his kids a bedtime story.

Still feeling out of sorts, Paul went to the kitchen to get a glass of water. But standing at the sink, the 46 year old experienced an eerie feeling.

“I just thought, ‘Hang on a minute. I can’t actually remember what we did today. What just happened?’” he recalls.

“I could remember that I’d just read the kids a bedtime story, but I couldn’t really remember the day. It was just very blurry. I thought, ‘There’s something strange going on’.”

Knowing he needed help, Paul asked Natalie to call an ambulance. The paramedics who came assessed Paul for stroke. Although he wasn’t showing any of the physical signs, his memory loss was a massive red flag.

“At that point, they started asking Paul questions. They said, ‘Do you remember what year you were married?’ He looked at me and he said, ‘2013’, which is incorrect,” Natalie recalls. “Then they asked him what the date was and he said, ‘I’m going to have to calculate that’.”

The paramedics then asked Paul if he’d had any surgery recently, explaining that medication, such as anti-inflammatory drugs, can occasionally impact memory. Natalie nodded, yes, Paul had had an operation on his bicep.

“Paul was looking at me and he’s like, ‘Surgery? What surgery?’ I said, ‘Look at your arm. You had surgery.’ He looked at the massive scar on his arm and he was extremely perplexed,” says Natalie.

Paul’s sudden memory loss was very troubling. The paramedics decided to take him into hospital for further tests. “It was very scary because I didn’t know what was going on,” Natalie tells MiNDFOOD.

“I was just trying to keep calm so that I could keep Paul calm. But I’d never experienced anything like it.” A CT scan confirmed that Paul had not had a stroke. And yet, his memory lapse was more pronounced than ever. “Paul looked at me and said, ‘So, I’ve had a stroke, have I?’ I said, ‘No. You haven’t had a stroke. They’ve done a CT scan and it’s clear. You’re okay.’ And then literally 30 seconds later he’d say, ‘So they think I’ve had a stroke?’” Natalie explains.

After a while Paul became fixated on the date. “He said, ‘So it’s the 6th of January, 2020? Oh, crikey.’ And Paul’s not one really to say the word ‘crikey’,” recalls Natalie. “He was talking like he had a few drinks under his belt. But at the same time, I had to reassure him for another half an hour, ‘Yes, it’s 2020.’ He just wasn’t retaining any information.” Although Paul knew exactly who Natalie was, he couldn’t remember anything about their summer holiday or that they’d spent the day driving back home from the coast. “I was trying to stay calm for him, but it was very, very scary,” Natalie recalls.

Eventually a doctor was able to provide some answers. Paul was experiencing an episode of Transient Global Amnesia (TGA), a sudden and temporary impairment of memory during which a person cannot learn or recall new information and may also have difficulty recalling old memories.

The incidence of TGA in the general population is low, with only 5.2 cases per 100,000 in the US. However, the frequency rises in people who are over the age of 50. Even so, it’s still unusual – with around 25 out of 100,000 on a yearly basis.

Dr Amee Baird, a clinical neuropsychologist, notes that while there have been hundreds of reported cases of TGA in the medical literature, the cause is still unknown. “It is regarded as one of the most mysterious of all the neurological conditions,” she says.

“It’s pretty rare. I’ve worked as a neuropsychologist for nearly 20 years and I’ve only seen two patients with TGA,” Baird adds. She notes that the mystery of TGA shows us that we still