Amnesia physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Patients with amnesia may have variable general appearance depending on the underlying cause of memory loss. Amnesia is largely a clinical diagnosis. Focal examination including vital signs, altered mental status, mini mental status exam (MMSE), Glasgow Coma Scale, nystagmus, papilledema, gait, instruments of daily activities should be assessed.

Patients with amnesia may have variable general appearance depending on the underlying cause of memory loss.

• Patients with memory loss could appear completely normal or may present with cognitive impairment, signs of head trauma, alcohol abuse.

• It is crucial to assess vital signs repeatedly and compare Glasgow Coma Scale scores in intervals for patients with recent history of head trauma with or without loss of consciousness.^[1]
• Vital Signs should include assessment of heart rate, blood pressure, oxygen saturation, and temperature.

• Skin examination of patients with memory loss is usually normal, signs of head trauma should be assessed.

• HEENT examination of patients with amnesia is usually normal. Abnormalities to be observed includes:
  • Evidence of trauma
  • Nystagmus in Korsakoff’s syndrome^[2]
  • Ophthalmoscope examination may be abnormal with findings of papilledema in case of head trauma.^[3]

• Neck examination of patients with amnesia is usually normal.

• Pulmonary examination of patients with amnesia is usually normal.

• Cardiovascular examination of patients with amnesia is usually normal.

• Abdominal examination of patients with amnesia is usually normal.

• Back examination of patients with amnesia is usually normal.

• Genitourinary examination of patients with amnesia is usually normal.

• Neuromuscular examination of patients with amnesia depends on the underlying cause.
• Patient’s orientation to persons, place, and time should be determined.
• Altered mental status
• Glasgow coma scale
• Mini-Mental Status Examination (MMSE)^[4]
• Montreal Cognitive Assessment (MOCA)
• Instruments of Activities of Daily Living (IADL)
• Muscle rigidity, abnormal gait

• Extremities examination of patients with amnesia is usually normal.

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