Global Amnesia from cold water???

[octgal]

This story happened last year, but i am posting it here as i would really like to hear a second opinion from another dive doctor, or if anyone else has ever heard of this or expierenced this.

Thanks in advance for helping me understand. I am just gonna copy and paste my report below from last year.

First...This isnt my story....I was only the buddie during this incident. I have permission from the person to post this for divers who i assume are just in the dark about this condition as i am.

This all started this tuesday evening around 1930 at the lighthouse in Tobermory. My buddie and I were gonna do a short wee dive. This diver has dove the site a few times already last year. So we get geared up and into the water we go. We go down and we do our OKs and we start our easy dive, well right away my buddie is lagging behind, so i tell this person to swim beside me (i like to keep an eye on new diver buddies) i get a half ass response and they still lag behind. After 15 mins i ask for an air check...this person fumbles (not like them) and looks at their gage, then looks at me (btw we are at 35 feet) I give the WELL WHATS THE AIR sign. This person responds by shugging their shoulders. I turn the dive immediately, not sure what the deal is, but i wasnt about to go further like that. We end the dive at 30 mins and surface after doing a 3 min saftey stop. I ask them "ok, whats the deal!!!" The person's response was "where are we?"!!!!!!

Once they said that, i asked "what???what do you mean, we are at the lighthouse.." they said "where?" I say "omg get out of the water RIGHT NOW!!!" i got them out while this person continued to ask the same things over and over again and saying they felt confused. Here i am now around 2130 all the shops closed, no idea where the nearest medical facility is and with my lack of medical expierence that this may be a stroke

This person is so out of it that they dont remember the last 24 hours!!!! They go from saying "wendy i am fine" to, crying cause they are scared, Me on the other hand is on the phone with DAN, and driving to the stupid pub to ask where the f&ck to go! This person started freaking out when they overheard me say that i would take them to the hospital so i had to lie to this personm about where we were going. I got them to see the dive doctor within around 25 mins, after a lot of calls and driving around. This person spent the night in the hospital and was diagnosed with Global Amnesia brought on by cold water.

So how many have heard of this???? just please be aware!!!

 

[fisherdvm]

Never heard of it. Interesting. I tend to have amnesia to things my wife tells me to do, but it is not temperature dependent.

 

[Ber Rabbit]

Sounds like just as frightening an experience for you as it was for them. Not knowing what's wrong with someone and not knowing where the closest medical facility is can be terrifying. You might want to start doing what we call an "Emergency Assistance Plan" (EAP) for your trips. We have our OW students find the closest hospital to every dive site we use. They print a map and turn by turn directions from the site to the closest hospital and put it in a red binder along with pertinent medical (allergies, medications, etc.), emergency contact and insurance information that the hospital will need when a patient gets there.

Tobermory is fairly easy to do an EAP for because you can just print a map of the town and mark the dive sites, medical center and chamber on it.
Ber :lilbunny:

 

[DocVikingo]

Hi octgal,

"Precipitants of TGA frequently include physical exertion, overwhelming emotional stress, pain, cold-water exposure, sexual intercourse, and Valsalva maneuver. These triggers may have a common physiologic feature: increased venous return to the superior vena cava."

Quoted from:

Transient Global Amnesia
eMedicine - Transient Global Amnesia : Article by Roy Sucholeiki, MD

I recall a case of it being discussed on another diving medicine forum about 2-3 years ago.

Regards,

DocVikingo

 

[boulderjohn]

My wife got TGA last year while doing some yard work on a cabin we own with relatives. It was indeed a frightening experience for her. I have since heard tales of it being so rare that medical personnel often misdiagnose it, but in my wife's case a nurse at the hospital nailed it immediately.

I was not even in the state at the time, and they were not able to reach me until the episode had passed. I talked to the neurologist first, who spoke to me as if I had a medical degree. (Fortunately I knew what terms like ischemia mean, but surprising that he would expect it.) The phone was then passed to my wife, who was able to joke about what had happened, even though she could not remember anything that had happened prior to an hour or two before our conversation.

As cured as she sounded on the phone, the next day she had no memory of talking with me at all.

There have been no after effects whatsoever.

 

[boat sju]

Hi octgal,

"Precipitants of TGA frequently include physical exertion, overwhelming emotional stress, pain, cold-water exposure, sexual intercourse, and Valsalva maneuver. These triggers may have a common physiologic feature: increased venous return to the superior vena cava."

Quoted from:

Transient Global Amnesia
eMedicine - Transient Global Amnesia : Article by Roy Sucholeiki, MD

I recall a case of it being discussed on another diving medicine forum about 2-3 years ago.

Regards,

DocVikingo

(I know this is an old thread but) my father-in-law experienced an episode of TGA last week. Upon Googling TGA I came across a similar, if not the same, paper as referenced above. Besides mentioning the Valsalva maneuver as a possible trigger, it also mentioned the use of Nitrox. If this is true I was curious why I've never heard of it on SB. Anyone know of data indicating that divers really have a higher incidence of TGA?

 

[Duke Dive Medicine]

(I know this is an old thread but) my father-in-law experienced an episode of TGA last week. Upon Googling TGA I came across a similar, if not the same, paper as referenced above. Besides mentioning the Valsalva maneuver as a possible trigger, it also mentioned the use of Nitrox. If this is true I was curious why I've never heard of it on SB. Anyone know of data indicating that divers really have a higher incidence of TGA?

Hi boat sju,
Great question. The below linked article abstract is a case report from Italy about two divers using nitrox (one 50/50, the other 32%) who were diagnosed with TGA following their dives. The authors did a thorough literature review and discussed the two cases in the article. They do not believe that the TGA was related to breathing a hyperoxic mixture.

Transient global amnesia after breathing hyperoxic... [Clin Neurol Neurosurg. 2008] - PubMed result

Reference:
Spigno F, De Lucchi M, Migliazzi L, Cocito L. Transient global amnesia after breathing hyperoxic mixtures in otherwise healthy dives. Clinical Neurology and Neurosurgery 110(2008) 259-261.

Best regards,
DDM

 

[boat sju]

Thanks DDM. Somehow I'm getting the impression that if you ate spicy food the day before an episode of TGA that spicy food might then be considered a possible trigger.

boat

 

[boulderjohn]

Thanks DDM. Somehow I'm getting the impression that if you ate spicy food the day before an episode of TGA that spicy food might then be considered a possible trigger.

I believe this is true about almost anything that happens in our lives for which there is no clear explanation available--we pick out something that happened before it and declare it the cause. You mention of spicy food as an example is interesting because I recently read an article on food poisoning. They said that food poisoning is actually extremely rare, but when people suddenly get sick, it is inevitably not long after they ate something, and whatever they ate gets blamed.

If you want to see an example of this in diving, do a DAN search for their article on taking Sudafed (and the like) before using nitrox. It is an interesting report because about half of it is on the topic of scientific studies themselves and how dangerous it is to assume a causal link between two events such as taking a common drug like Sudafed before diving and then suffering a CNS episode. The purpose of their doing so was clearly to tell people to take whatever conclusions the study drew with a large dose of salt.

 

[Charlie99]

@ Octgal --- what sort of water temperature and what sort of exposure protection was your buddy wearing? Had he done that dive before? Did he exhibit signs of hypothermia such as purple lips, shivering, etc?

Was he having problems equalizing, and therefore doing vigorous Vasalva maneuvers (listed by Doc V. as a possible cause)?