Child Neurology: Transient Global Amnesia Precipitated by a Valsalva Maneuver in an Adolescent

Transient global amnesia (TGA) is a benign clinical syndrome characterized by the sudden onset of anterograde amnesia with preserved consciousness and no focal neurologic deficits, resolving within 24 hours. It predominantly affects middle-aged and older adults and is rarely reported in pediatric populations. In adults, TGA is often preceded by identifiable triggers, including Valsalva maneuvers. We describe a previously healthy, typically developing 16-year-old boy who presented with acute anterograde amnesia after an intentional Valsalva maneuver performed during a school video. He experienced several hours of repetitive questioning, inability to form new memories, and mild retrograde amnesia. The episode of anterograde amnesia resolved spontaneously after approximately 9 hours. He subsequently regained some memories of the period preceding symptom onset. Neurologic examination after symptom resolution was normal aside from amnesia for the episode itself. Laboratory investigations, head CT, electroencephalography, and brain magnetic resonance imaging were unremarkable aside from a hypoplastic left transverse sinus without evidence of thrombosis. The clinical presentation was therefore felt to be most consistent with TGA precipitated by a Valsalva maneuvers. This case highlights a rare presentation of TGA in an adolescent precipitated by a Valsalva maneuver. It underscores the importance of considering TGA in the differential diagnosis of acute anterograde amnesia in pediatric patients and suggests overlap between recognized triggers of TGA in adults and those observed in children.