Q&A: What is the memory erasing condition Katie Couric experienced?

University of Virginia cerebrovascular neurologist Dr. Bradford Worrall explains what happened to Couric, who graduated from UVA in 1979 with a degree in American studies. He discusses what researchers know – and still don’t know – about what causes the condition, why it differs from a stroke and why anyone with symptoms should seek emergency care.

Q. What is transient global amnesia?

A. Its name really gives it all away. It is a temporary loss of almost all non-procedural memory. Somebody who has transient global amnesia would still be able to drive a car, ride a bicycle and do other routine activities, because procedural memory is preserved, but factual memory is impaired. 

Katie Couric is a 1979 graduate of UVA and was the head Lawn resident her fourth year. Her portrait hangs on the first floor of Clemons Library, part of the President’s Portrait Series that highlights people who have made significant contributions to the University. (Photo by Matt Riley, University Communications)

The prototypical presentation is a patient brought in by family, acting confused and asking the same question over and over again. Once you’ve seen someone with it, it’s actually quite easy to recognize because it’s such a striking presentation. People tend to know their own name, but they often don’t recognize people or understand the situation they’re in.

Q. What is the cause? 

A. The triggers are sometimes not recognized, but there are definite things that are known to trigger it. The risk factors include a history of migraines and a history of hypertension. It is not infrequently triggered by emotional stress or vigorous physical exercise. It is kind of mysterious.

Q. What symptoms should family members watch for?

A. The sudden onset of not recognizing other people, not recognizing situations and asking the same questions over and over again, but otherwise appearing normal. They’re not laying down new memory. That’s why they keep asking questions over and over again, even though they’ve been told the answer.

Q. Do patients realize something is wrong?

A. They do know something’s wrong. They’re often very distressed, but they don’t know exactly why. You can imagine how disorienting that would be. When you see someone who has recovered from it, they generally have a hole in their memory during the period when they weren’t laying down memory, but other than that, they have no long-term untoward effects.

Q. How long do episodes usually last?

A. It’s generally supportive to reassure patients and the family that this is something that will likely pass in an hour up to maybe 12 hours. If symptoms last longer than that, you start to worry about other potential causes of amnesia.

Q. Does having one episode mean you’re likely to have another one?

A. We don’t have great data on that. It is certainly not rare for it to recur, but we don’t really have a good estimate for how likely a recurrence is.

Q. Is transient global amnesia linked to stroke or dementia?

A. The epidemiology suggests that people with transient global amnesia are not necessarily at increased risk of stroke. And to make it very clear, people with (transient global amnesia) are not necessarily at any increased risk for developing dementia.

Q. Should someone with symptoms go to the emergency room, even though transient global amnesia resolves on its own?

A. They should come to the emergency room because there are too many other things that can look like transient global amnesia. I’ve seen patients whose symptoms looked exactly like (transient global amnesia) who ultimately turned out to have seizure disorders. That’s why it’s a good idea to come in for an evaluation, just for reassurance.