Transient Global Amnesia After Screening Esophagogastroduodenoscopy: Incidence and Risk Factors in a 20-Year...

Transient global amnesia (TGA) after esophagogastroduodenoscopy (EGD) has been described only in case reports. Because sudden-onset amnesia can mimic stroke and other acute central nervous system disorders, TGA requires careful differentiation in the acute setting, and clinicians need to be familiar with this condition. We estimated its incidence after screening EGD and identified associated risk factors in a large single-center cohort.

We retrospectively reviewed 420,979 screening EGDs at a single health checkup center (April 2005-March 2025). All EGDs were performed without sedation, using topical pharyngeal anesthesia only. TGA cases were ascertained from the endoscopy adverse-event registry and confirmed. For analyses, three non-TGA controls per TGA case (1:3 ratio) were randomly selected from examinees undergoing EGD on the same calendar date, using same-day matching. Odds ratios (ORs) were estimated using conditional logistic regression.

TGA occurred in 64 episodes in 63 individuals of 420,979 examinations (0.0152%). In route-specific analyses from April 2008, the transoral route carried a higher risk than the transnasal route (Fisher's exact test p = 0.013). In multivariable matched models, older age (odds ratio [OR] 2.32 per 10-year increase; 95% confidence interval [CI], 1.38-3.92), female sex (14.6; 4.82-43.9), transoral insertion (10.2; 1.88-55.4), and treated dyslipidemia (2.84; 1.20-6.73) were statistically associated. EGD time and endoscopist experience were not associated.

The incidence of post-EGD TGA was very low at 15.2 per 100,000 examinations (0.0152%). Older age, female sex, transoral insertion, and treated dyslipidemia were independently associated with post-EGD TGA. A transnasal approach might be a potential risk-reduction strategy.