1) Amnestic disorders can be divided into three categories: those due to a general medical condition, substance-induced, or amnestic disorder not otherwise specified. 2) The most common causes are alcohol use disorders, head injuries, and thiamine deficiency from alcohol dependence. Memory impairment involves an inability to learn new information or recall past events while other cognitive abilities remain intact. 3) Diagnosis involves determining the etiology based on history, exam, and labs. Treatment focuses on addressing the underlying medical condition causing the amnesia through supportive measures or psychotherapy after resolution.

1. AMNESTIC
DISORDER
BY GROUP 5
SUPERVISED BY: DR UMEED

2. Introduction
 Can be divided into three broad categories:
1. Amnestic disorder due to a general medical
condition
2. Susbtance-induced persisting amnestic disorder
3. Amnestic disorder not otherwise specified
(NOS)
 Transient: < 1 month
 Chronic: >1month

3. Epidemiology & etiology
 No adequate studies have reported incidence
or prevalence
 Most commonly found in alcohol use disorders
and head injury
 Most common form is caused by thiamine
deficiency associated with alcohol
dependence
 Any process that damages certain
diencephalic and medial temporal structures
can cause the disorder

4. Major Causes of Amnestic
Disorders
 Systemic medical conditions
Thiamine deficiency (Korsakoff's syndrome)
Hypoglycemia
Primary brain conditions
Seizures
Head trauma (closed and penetrating)
Cerebral tumors (especially thalamic and temporal lobe)
Cerebrovascular diseases (especially thalamic and temporal lobe)
Surgical procedures on the brain
Encephalitis due to herpes simplex
Hypoxia (including nonfatal hanging attempts and carbon monoxide
poisoning)
Transient global amnesia
Electroconvulsive therapy
Multiple sclerosis
 Substance-related causes
Alcohol use disorders
Neurotoxins
*Benzodiazepines (and other sedative-hypnotics)
Many over-the-counter preparations

5. Diagnosis, sign and symptoms
 Essential feature: impaired ability to learn and
recall new information coupled with inability to
recall past events
 Other areas of cognition are normal.
 Diagnosed according to etiology

6. Clinical features
 Impairment in ability to learn new information
(antegrade amnesia)
 Inability to recall previously remembered
knowledge (retrograde amnesia)
 Short term and recent memory usually
impaired
 Memory from the remote past is preserved
(e.g childhood), but memory from the less
remote past is impaired (e.g last decade)
 Onset can be sudden ( trauma or
cerebrovascular events) or gradual (nutritional
deficiency)
 Subtle and gross changes in personality can
occur

7. DSM-IV-TR Diagnostic Criteria for Amnestic
Disorder Due to a General Medical
Condition
A. The development of memory impairment as manifested by
impairment in the ability to learn new information or the inability to
recall previously learned information.
B. The memory disturbance causes significant impairment in social or
occupational functioning and represents a significant decline from a
previous level of functioning.
C. The memory disturbance does not occur exclusively during the
course of a delirium or a dementia.
D. There is evidence from the history, physical examination, or
laboratory findings that the disturbance is the direct physiological
consequence of a general medical condition (including physical
trauma).
 Specify if:
Transient: if memory impairment lasts for 1 month or less
Chronic: if memory impairment lasts for more than 1 month
 Coding note: Include the name of the general medical condition on
Axis I, e.g., Amnestic disorder due to head trauma; also code the
general medical condition on Axis III

8. DSM-IV-TR Diagnostic Criteria for
Substance-Induced Persisting Amnestic
Disorder
A. The development of memory impairment as manifested by
impairment in the ability to learn new information or the inability to
recall previously learned information.
B. The memory disturbance causes significant impairment in social or
occupational functioning and represents a significant decline from a
previous level of functioning.
C. The memory disturbance does not occur exclusively during the
course of a delirium or a dementia and persists beyond the usual
duration of substance intoxication or withdrawal.
D. There is evidence from the history, physical examination, or
laboratory findings that the memory disturbance is etiologically
related to the persisting effects of substance use (e.g., a drug of
abuse, a medication).
 Code (Specific substance)-induced persisting amnestic disorder:
(Alcohol; Sedative, hypnotic, or anxiolytic; Other [or unknown]
substance)

9. DSM-IV-TR Diagnostic Criteria for
Amnestic Disorder Not Otherwise
Specified
 This category should be used to diagnose an
amnestic disorder that does not meet criteria
for any of the specific types described in this
section.
 An example is a clinical presentation of
amnesia for which there is insufficient
evidence to establish a specific etiology (i.e.,
dissociative, substance induced, or due to a
general medical condition).

10. Differential diagnosis
 Delirium and dementia
 Factitious disorders (mimicking an amnestic disorder, often
have inconsistent results on memory tests)
 Dissociative disorders (lost their orientation to self and may
have more selective memory deficits, associated with emotionally
stressful life events )
 Alzheimer’s disease
 Dementias associated with Parkinson’s disease,
AIDS, and other subcortical disorders (display motor
symptoms, such as bradykinesia, chorea, or tremor)
 Normal aging (minor impairment in memory cause significant
impairment in social or occupational functioning)

11. Comparison of Syndrome
Characteristics in Alzheimer's Disease
and Amnestic Disorder
Characteristic Alzheimer's Dementia Amnestic Disorder
Onset Insidious Can be abrupt
Course Progressive
deterioration
Static or improvement
Anterograde memory Impaired Impaired
Retrograde memory Impaired Temporal gradient
Episodic memory Impaired Impaired
Semantic memory Impaired Intact
Language Impaired Intact
Praxis or function Impaired Intact

12. Course and prognosis
 Amnestic disorder has a static course. No
improvement/ little progression
 Acute amnesias resolve entirely over hours to
days ex: transient global amnesia
 Amnestic disorder associated with head
trauma improves steadily in the months
subsequent to trauma
 Amnesias secondary to processes that destroy
brain tissue are irreversible ex: stroke, brain
infection

13. Treatment
 Treat underlying cause
 Supportive prompts about date, time, and
patient’s location
 After resolution of the amnestic episode 
psychotherapy

14. Thank u for your attention!