Impressed with the number of patients whose spells of transient global amnesia were triggered by special circumstances, I have reviewed 78 such cases. Precipitating events were reported in 26 of 85 spells: eight occurred during highly emotional experiences; seven, during sexual intercourse; six, while the patient was in pain; two, while a trigeminal ganglion was being stimulated; and three, during a dip in the cold Atlantic Ocean. These observations suggest an electrophysiologic disturbance. The characteristics of the amnesia, the organization of memory, and behavior during spells were also considered.