Exploring the recollective experience during autobiographical memory retrieval in amnestic mild cognitive impairment.

Autonoetic consciousness refers to the ability to mentally transport oneself back in subjective time to relive elements of, or all, of a past event, and is compromised in the early stages of Alzheimer's disease (AD). Here, we investigate autobiographical memory (ABM) and the recollective experience in amnestic mild cognitive impairment (aMCI). aMCI participants exhibited significant deficits compared with healthy elderly controls for both personal semantic and event detail components of ABM. These decrements were evident across all life epochs for episodic recall. Recall of an event that occurred 1 week previously, was tested in the same spatiotemporal context, and provided the greatest group dissociation, with elderly controls benefitting from a context-dependent memory effect. This reinstantiation of context did not ameliorate the anterograde deficits in the aMCI cohort, nor did it facilitate the mental reliving of these memories for either participant group. Whereas reliving judgments were comparable in both groups, aMCI participants exhibited a compromised capacity to generate vivid, self-referential visual imagery and to re-experience the original emotion of events. These contextual and experiential deficits extended beyond recently encountered events into remote epochs, and suggest a greater level of ABM impairment in aMCI than previously assumed.

A patient of migraine-like headache with amnesia, pleocytosis and transient hypoperfusion of cerebral blood flow.

Pseudomigraine with pleocytosis (PMP) is an uncommon disease in Japan. The diagnostic criteria include at least one episode of transient neurological deficit accompanied or followed by migraine-like severe headache, cerebrospinal fluid (CSF) lymphocytosis, and normal neuroimaging. Both the etiology and the pathophysiology of PMP is not yet well defined. We report a 40-year-old man with a PMP-like syndrome. He came to our clinic because of severe throbbing headache and amnesia, and the examination showed CSF lymphocytosis of 23/mm3, a transient decrease of cerebral blood flow in the left thalamus. All the symptoms were completely resolved within 2 months.

Hypnotic recall: a positive criterion in the differential diagnosis between epileptic and pseudoepileptic seizures.

PURPOSE: Because the diagnosis of pseudoepileptic seizures (PESs) is mostly made by excluding epilepsy, availability of a positive criterion for PESs is of great importance. This study was aimed at the validation of a diagnostic technique that intends to provide in such a positive criterion. METHODS: In 17 patients with epileptic seizures (ESs) and 20 patients with PESs, a hypnotic procedure was performed by an investigator blind to other data to recover amnesia for the ictus. If recall was obtained, the experimental diagnosis PES was given; if not, ES was diagnosed. The experimental diagnoses were compared with the clinical, EEG-confirmed diagnoses. Hypnotizability was measured to determine the relation between the outcome of the test and hypnotizability of the patients. RESULTS: Recall for the ictus was obtained in 17 patients. Each of these had a clinical diagnosis of PES. Seventeen patients with "no recall" had a clinical diagnosis of ES, and three patients had PESs. This result yields a specificity of 100% and a sensitivity of 85% for the recall technique. Hypnotizability was significantly higher in patients with PESs than in patients with ESs. In some "low hypnotizables," recall was obtained, and in some "high hypnotizables," no recall was obtained. CONCLUSIONS: A positive recall test indicates PES. A sub-group of patients with PESs is characterized by a high level of hypnotizability. Hypnotizability is not crucial for outcome of the recall test. High hypnotic abilities are especially found in disorders in which it is supposed that "dissociation" is involved. It can be speculated that PES may be one of the dissociative phenomena.

The case for a dissociative interpretation of pseudoepileptic seizures.

A pseudoepileptic seizure (PES) can be considered as a paroxysmal behavior pattern that mimics epilepsy and is initiated by psychological mechanisms. There is no evidence that the symptomatology of PES forms a specific syndrome. This paper presents evidence for the explanatory value of the concept of dissociation in at least a subgroup of PES. Characteristics of patients with PES and possible factors in the etiology of PES are reviewed. Based on the dissociation hypothesis, some suggestions are offered to explain the relatively high comorbidity of PES and epilepsy.

Prevalence of multiple personality among inpatients and outpatients.

A survey of psychiatric inpatients (N = 50) and outpatients (N = 100) indicated that about 10% had multiple personality and an additional 5%-20% had amnesia for early traumatic experiences.