Tadalafil-induced transient global amnesia.

Case Report A 48-year-old man presented with sudden memory impairment. His medical history was relevant for mild dyslipidemia and long-standing impotence. Tadalafil had been prescribed for the first time the day before. After taking a 25 mg pill, and not getting an erection, he decided to sleep. He was not anxious, did not hyperventilate, and did not undergo any physical activity before sleeping. He woke up the next morning unable to remember things from the week before— such as the previous day’s medical consultation, that he had been installing new lamps in the house, or that a tree fell in his yard— seeming surprised and irritated every 5 minutes, and repetitively questioning his wife about this. He was otherwise normal, capable of dressing, cooking breakfast, and even driving to the hospital. When observed he was fully alert, cooperative and orientated. He could not recall any event from the previous week until that moment, not remembering getting up, dressing, or driving. He retrieved 1 word from 5 after a 5-minute delay and could not recall the doctor’s name. Semantic and autobiographic memories were normal, as was the whole physical and remaining neurological examination. EEG and brain MRI showed no abnormality, with normal diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) sequences. Memory abnormality started to gradually fade, with almost complete recollection of past events by the 8th hour after symptom onset, leaving a memory gap for this period. Two days later there was only inability to recall what occurred in that morning. MRI again failed to depict any abnormality.