ABSTRACT
Temporal lobe epilepsy is known to present with various cognitive impairments, among which memory deficits are frequently reported by patients. Memory deficits can be classified into two types: classical hippocampal amnesia, which is characterized by abnormalities detected in neuropsychological assessments, and atypical memory deficits, such as accelerated long-term amnesia and autobiographical memory impairment, which cannot be identified using standard testing methods. These deficits are believed to arise from a complex interplay among structural brain abnormalities, interictal epileptic discharges, pharmacological factors, and psychological states. While fundamental treatments are limited, there are opportunities for interventions such as environmental adjustments and rehabilitation. This review article aims to provide a comprehensive overview of the types, underlying pathophysiology, and intervention methods for memory disorders observed in patients with temporal lobe epilepsy.
Subject(s)
Epilepsy, Temporal Lobe , Memory Disorders , Epilepsy, Temporal Lobe/complications , Humans , Memory Disorders/etiology , Hippocampus , Amnesia/etiologyABSTRACT
After moderate to severe traumatic brain injury (TBI), sleep disturbance commonly emerges during the confused post-traumatic amnesia (PTA) recovery stage. However, the evaluation of early sleep disturbance during PTA, its recovery trajectory, and influencing factors is limited. This study aimed to evaluate sleep outcomes in patients experiencing PTA using ambulatory gold-standard polysomnography (PSG) overnight and salivary endogenous melatonin (a hormone that influences the sleep-wake cycle) assessment at two time-points. The relationships between PSG-derived sleep-wake parameters and PTA symptoms (i.e., agitation and cognitive disturbance) were also evaluated. In a patient subset, PSG was repeated after PTA had resolved to assess the trajectory of sleep disturbance. Participants with PTA were recruited from Epworth HealthCare's inpatient TBI Rehabilitation Unit. Trained nurses administered overnight PSG at the patient bedside using the Compumedics Somté portable PSG device (Compumedics, Ltd., Australia). Two weeks after PTA had resolved, PSG was repeated. On a separate evening, two saliva specimens were collected (at 24:00 and 06:00) for melatonin testing. Results of routine daily hospital measures (i.e., Agitated Behavior Scale and Westmead PTA Scale) were also collected. Twenty-nine patients were monitored with PSG (mean: 41.6 days post-TBI; standard deviation [SD]: 28.3). Patients' mean sleep duration was reduced (5.6 h, SD: 1.2), and was fragmented with frequent awakenings (mean: 27.7, SD: 15.0). Deep, slow-wave restorative sleep was reduced, or completely absent (37.9% of patients). The use of PSG did not appear to exacerbate patient agitation or cognitive disturbance. Mean melatonin levels at both time-points were commonly outside of normal reference ranges. After PTA resolved, patients (n = 11) displayed significantly longer mean sleep time (5.3 h [PTA]; 6.5 h [out of PTA], difference between means: 1.2, p = 0.005). However, disturbances to other sleep-wake parameters (e.g., increased awakenings, wake time, and sleep latency) persisted after PTA resolved. This is the first study to evaluate sleep disturbance in a cohort of patients as they progressed through the early TBI recovery phases. There is a clear need for tailored assessment of sleep disturbance during PTA, which currently does not form part of routine hospital assessment, to suggest new treatment paradigms, enhance patient recovery, and reduce its long-term impacts.
Subject(s)
Amnesia , Brain Injuries, Traumatic , Melatonin , Polysomnography , Recovery of Function , Sleep Wake Disorders , Humans , Brain Injuries, Traumatic/complications , Male , Female , Adult , Middle Aged , Amnesia/etiology , Sleep Wake Disorders/etiology , Recovery of Function/physiology , Young Adult , Saliva/metabolismABSTRACT
OBJECTIVE: Enduring anterograde amnesia is caused by lesions in bilateral mesial temporal lobes. However, whether transient dysfunction of bilateral mesial temporal regions induces reversible amnesia has not been proven. We investigated this association in patients with epilepsy and analyzed the electroclinical correlation during pure amnestic seizures (PAS). PAS are defined as seizures with anterograde amnesia as the only ictal manifestation, accompanied by preserved responsiveness and other cognitive functions. METHODS: We retrospectively searched our intracranial EEG database to find PAS. Pure ictal amnesia was confirmed by immediate and comprehensive ictal examinations. RESULTS: Among 401 patients who underwent intracranial EEG recording, three patients with temporal lobe epilepsy (TLE) manifesting PAS were identified. The patients talked and behaved normally during seizure but did not remember the episodes afterwards. Ictal discharges were confined to bilateral mesial temporal regions, with no or mild involvement of surrounding structures. Spread of low-voltage fast activities to bilateral mesial temporal regions corresponded to onset of ictal anterograde amnesia. Two patients underwent unilateral mesial temporal resection and became seizure-free with improvement in cognitive functions. SIGNIFICANCE: PAS is a rare ictal semiology in TLE. Bilateral mesial temporal regions that play a critical role in memory encoding are presumably the symptomatogenic zones for PAS.
Subject(s)
Epilepsy, Temporal Lobe , Seizures , Humans , Epilepsy, Temporal Lobe/physiopathology , Epilepsy, Temporal Lobe/surgery , Adult , Male , Female , Retrospective Studies , Seizures/physiopathology , Amnesia, Anterograde/physiopathology , Amnesia, Anterograde/etiology , Electroencephalography , Electrocorticography , Middle Aged , Amnesia/physiopathology , Amnesia/etiology , Temporal Lobe/physiopathologyABSTRACT
OBJECTIVE: The aim of this scoping review was to identify behavioral disturbances exhibited by patients in post-traumatic amnesia (PTA). While behavioral disturbances are common in PTA, research into their presentation and standardized measures for their assessment are limited. DESIGN: The study protocol was registered with PROSPERO (CRD42021268275). A scoping review of databases was performed according to pre-determined criteria on 29 July 2021 and updated on 13 July 2022. A conventional content analysis was used to examine and categorize behavioral disturbances. RESULTS: Thirty papers met the inclusion criteria, of which 27 reported observations and/or scores obtained on behavioral scales, and 3 on clinician interviews and surveys. None focused exclusively on children. Agitation was the most frequently assessed behavior, and Agitated Behavior Scale was the most used instrument. Content analysis, however, bore eight broad behavioral categories: disinhibition, agitation, aggression, lability, lethargy/low mood, perceptual disturbances/psychotic symptoms, personality change and sleep disturbances. CONCLUSION: Our study revealed that while standardized assessments of behavior of patients in PTA are often limited to agitation, clinical descriptions include a range of behavioral disturbances. Our study highlights a significant gap in the systematic assessment of a wide range of behavioral disturbances observed in PTA.
Subject(s)
Brain Injuries, Traumatic , Problem Behavior , Child , Humans , Amnesia/etiology , Amnesia/diagnosis , Amnesia, Retrograde , Anxiety , AggressionABSTRACT
OBJECTIVE: A comparative study of joint amnesia in patients undergoing total hip arthroplasty with the direct anterior approach and posterior approach was conducted through a comprehensive evaluation. METHODS: The literature on joint amnesia in postoperative patients who underwent total hip arthroplasty by the direct anterior approach and the posterior approach was systematically searched in PubMed, Embase, Web of Science, Cochrane Library, CNKI, CBM, Wanfang, and VIP databases from the time of library construction until February 13, 2023. Meta-analysis was performed using RevMan 5.3 software after independent searching, screening of the literature, data extraction, and quality assessment of the included studies by two investigators in strict accordance with the guidelines for conducting meta-analyses. RESULTS: A total of one RCT and six cohort studies were included in this meta-analysis. Meta-analysis results indicated that at 1 month postoperatively (MD = 2.08, 95% CI (0.20, 3.96), P = 0.03), 3 months (MD = 10.08, 95% CI (1.20, 18.96), P = 0.03), and 1 year (MD = 6.74, 95% CI (1.30, 12.19), P = 0.02), DAA total hip arthroplasty was associated with better FJS compared to PA at 1 year postoperatively. However, there was no statistical significance in FJS between the two groups at 5 years postoperatively (MD = 1.35, 95% CI (- 0.58, 3.28), P = 0.17). CONCLUSION: Current evidence suggests that the degree of joint amnesia after THA for DAA was not found to be superior to that of PA. Further, these findings require confirmation by including a larger number of high-quality randomized controlled studies. STUDY DESIGN: Systematic review; Level of evidence, 3.
Subject(s)
Arthroplasty, Replacement, Hip , Humans , Arthroplasty, Replacement, Hip/adverse effects , Amnesia/etiology , Databases, Factual , Postoperative Period , Quality ControlABSTRACT
Isolated fornix anterior column infarction has rarely been described and is difficult to assess accurately using conventional magnetic resonance imaging (MRI). We report the case of a 75-year-old female who experienced acute anterograde amnesia. MRI performed within 24 h after amnesia onset showed an isolated infarction of the bilateral anterior columns of the fornix on diffusion-weighted imaging (DWI). Her symptoms persisted for up to 50 days, and diffusion tensor imaging (DTI) showed disruption of the fiber tracts of the fornix. when acute amnesia syndrome onset, fornix anterior column infarction should be considered, and optimized DWI and DTI methods are needed to study the fornix in vivo in future research.
Subject(s)
Diffusion Tensor Imaging , Fornix, Brain , Humans , Female , Fornix, Brain/diagnostic imaging , Fornix, Brain/pathology , Aged , Diffusion Magnetic Resonance Imaging , Amnesia, Anterograde/etiology , Amnesia/etiology , Amnesia/diagnostic imaging , Cerebral Infarction/diagnostic imaging , Cerebral Infarction/complicationsABSTRACT
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Subject(s)
Humans , Male , Middle Aged , Positron Emission Tomography Computed Tomography/methods , Limbic Encephalitis/diagnostic imaging , Fluorodeoxyglucose F18/administration & dosage , Amnesia/etiology , Small Cell Lung Carcinoma/diagnostic imaging , Adrenal Cortex Hormones/therapeutic useABSTRACT
Introducción. La amnesia aguda aislada es una forma excepcional de presentación del ictus talámico. Se analizan el perfil clínico, el diagnóstico, el tratamiento y el pronóstico de estos pacientes. Casos clínicos. Revisión retrospectiva de los casos de infarto talámico que se presentaron exclusivamente como amnesia aguda en nuestro hospital terciario universitario (n = 3) y revisión de casos similares en PubMed (n = 20). El 48% presentaba al menos un factor de riesgo de ictus (hipertensión arterial, dislipidemia, diabetes mellitus, fibrilación auricular o ictus previo). La amnesia fue anterógrada en tres casos (13%) y global en los otros 20 (87%). El infarto se detectó en estudio de neuroimagen en las primeras 24 horas en un paciente (4%) y posteriormente en los demás, y la media de días hasta el diagnóstico fue de 11. La tomografía computarizada inicial fue normal en cinco (22%) pacientes. Precisaron estudio por resonancia magnética ocho (35%) casos para detectar el infarto. De éstos, cuatro sujetos se estudiaron directamente con resonancia magnética. La amnesia presentó una mejoría clara en ocho (35%) pacientes, y la recuperación fue completa en tres (13%). Las secuelas mnésicas que interferían la capacidad funcional se presentaron en 15 pacientes (65%). La clínica persistió menos de 24 horas en dos pacientes (9%). Ningún caso recibió tratamiento revascularizador en fase aguda. Conclusión. Los infartos talámicos que comienzan de forma exclusiva con amnesia presentan notables dificultades diagnósticas que repercuten negativamente en su tratamiento en la fase aguda. Estos infartos pueden producir un déficit mnésico funcionalmente discapacitante en un porcentaje elevado de pacientes
Introduction. Isolated acute amnesia is an exceptional presenting symptom of thalamic stroke. This study analyses the clinical profile, the diagnosis, the treatment and the prognosis of these patients. Case reports. We conducted a retrospective review of the cases of thalamic infarct that presented exclusively as acute amnesia in our university tertiary hospital (n = 3) and a review of similar cases in PubMed (n = 20). 48% presented at least one risk factor of stroke (arterial hypertension, dyslipidaemia, diabetes mellitus, atrial fibrillation or a previous stroke). Amnesia was anterograde in three cases (13%) and global in the remaining 20 (87%). The infarct was detected in neuroimaging studies carried out within the first 24 hours in one patient (4%) and later in all the others; the average time until a diagnosis was established was 11 days. The initial CT scan was normal in five patients (22%). Eight cases (35%) required magnetic resonance imaging to detect the infarct. Of these, four subjects were studied directly with MR imaging. Amnesia clearly improved in eight patients (35%), and three of them (13%) made a full recovery. Fifteen patients (65%) presented mnemonic sequelae that interfered with their functional capacity. The clinical picture lasted less than 24 hours in two patients (9%). None of the cases received revasculisation therapy in the acute phase. Conclusion. The diagnosis of thalamic infarcts that begin exclusively with amnesia is very difficult and this has negative repercussions on their treatment in the acute phase. These infarcts can produce a functionally disabling memory deficit in a high percentage of patients
Subject(s)
Humans , Male , Aged , Thalamic Diseases/complications , Thalamic Diseases/diagnosis , Cerebral Infarction/complications , Infarction/diagnostic imaging , Amnesia/etiology , Tomography, X-Ray Computed , Magnetic Resonance Imaging , Infarction/therapy , Acute Disease , PrognosisABSTRACT
Este estudo compara a qualidade de vida das vítimas que apresentaram amnésia pós-traumática de longa duração com as demais e analisa a relação entre qualidade de vida e duração da amnésia pós-traumática, computando ou não o período de coma. Estudo de coorte prospectivo, com coleta de dados durante a internação hospitalar e avaliação da qualidade de vida no período de estabilidade da recuperação pós-traumática. Participaram desta investigação vítimas de trauma crânio-encefálico contuso, maiores de 14 anos, sem antecedentes de demência ou trauma crânio-encefálico, internadas em hospital de referência para atendimento de trauma nas primeiras 12 horas pós-evento. Os resultados referentes à qualidade de vida foram mais desfavoráveis em três domínios do grupo com amnésia de longa duração. Correlações entre duração da amnésia e domínios de qualidade de vida foram mais expressivas quando excluído o período de coma, indicando que este tempo não deve ser computado na duração da amnésia pós-traumática.
The present study aims to compare quality of life of victims with long and short term post-traumatic amnesia and to analyze the relation between quality of life and length of amnesia, including or not the comatose period. This prospective cohort study, gathered data during the hospital stay and 3 and 6 months post- trauma. Blunt traumatic brain injury patients, over 14 years old, with no prior diagnosis of dementia or brain injury, admitted to a trauma center 12 hours post-trauma were included. The results were unfavorable among patients with long term amnesia. Correlation between length of post-traumatic amnesia and quality of life domains were more expressive when excluded comatose period, indicating that it must not be computed in the length of post-traumatic amnesia.
Este estudio tuvo compara la calidad de vida de las víctimas que tuvieron amnesia post-traumática a largo plazo, con los (las) demás y analizar la relación entre la calidad de vida y duración de la amnesia post-traumática, computando o nó el periodo de estado de coma. Estudio prospectivo de cohorte utilizando datos de hospitales y de la calidad de vida de víctimas de traumatismo craneoencefálico, internados en un hospital de referencia para la atención del trauma. Los resultados relativos a la calidad de vida eran más desfavorables en el grupo a largo plazo de amnesia. Las correlaciones entre la duración de la amnesia post-traumática y los dominios de la calidad de vida fueron más significativos cuando se excluyó el periodo de estado de coma, lo que indica que este tiempo no debe ser contado en la duración de la amnesia post-traumática.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Amnesia/etiology , Craniocerebral Trauma/complications , Quality of Life , Prospective StudiesABSTRACT
Introducción. La amnesia del desarrollo es una entidad de reciente conocimiento que se presenta como secuela de eventos hipóxico-isquémicos en la etapa perinatal. Se trata de un déficit específico de la memoria episódica con mejor preservación e la memoria semántica y otros componentes de la memoria, como son la memoria inmediata y la de trabajo. Se presenta en pacientes sin secuelas neurológicas aparentes, con un desarrollo psicomotor y una inteligencia general normales. La amnesia del desarrollo se ha asociado a la afectación bilateral del hipocampo, evidente en algunos casos en la resonancia magnética en forma de alteración de la señal y signos de atrofia, o bien disminución del tamaño del hipocampo en estudios volumétricos cerebrales.Pacientes y métodos. Se presentan seis observaciones de amnesia del desarrollo, su cuadro clínico, exploración neuropsicológica y hallazgos de neuroimagen. Resultados. Todos ellos muestran una alteración de la memoria episódica con preservación de la memoria semántica. Presentan una inteligencia general normal y siguen una escolarización ordinaria con necesidades educativas especiales. Conclusiones. Es necesario tener presente esta entidad en el seguimiento de los recién nacidos de riesgo por sus antecedentes perinatales e incluir la exploración de la memoria en el estudio neuropsicológico de estos sujetos. Por otra parte, se señala la especificidad del cuadro clínico y del perfil neuropsicológico para el diagnóstico de la amnesia del desarrollo aun en ausencia de lesiones del hipocampo en la resonancia magnética convencional (AU)
Introduction. The developmental amnesia is a recently known entity that occurs as a consequence of hypoxic-ischemic events in the perinatal period. This is a specific deficit of episodic memory with greater preservation of semantic memory and other memory components such as the immediate and working memory. It occurs in patients without apparent neurological sequelae, with normal psychomotor development and general intelligence. The developmental amnesia hasbeen associated with bilateral involvement of the hippocampus, which is evident in some cases on magnetic resonance imaging (MRI) as signal disturbance and signs of atrophy, or reduced size of the hippocampus in brain volumetric studies. Patients and methods. We present six observations of developmental amnesia, their clinical, neuropsychological and neuroimaging findings. Results. All of them show impaired episodic memory with preservation of semantic memory, have a normal general intelligence and follow a regular school with special educational needs. Conclusions. It is necessary to keep in mind this entity in monitoring risk newborns by their perinatal history and include the exploration of memory in neuropsychological study of these subjects. On the other hand, we highlight the specificity of the clinical and neuropsychological profile for the diagnosis of developmental amnesia even in the absence of hippocampal lesions on conventional MR (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Child , Asphyxia Neonatorum/complications , Amnesia/etiology , Memory Disorders/etiology , Hippocampus/injuries , Risk Factors , Neuropsychological TestsABSTRACT
No disponible
No disponible
Subject(s)
Humans , Female , Aged , Amnesia/etiology , Cerebral Hemorrhage/complications , Hematoma/complications , Corpus CallosumABSTRACT
It is controversial whether isolated lesions of mammillothalamic tract (MTT) produce significant amnesia. Since the MTT is small and adjacent to several important structures for memory, amnesia associated with isolated MTT infarction has been rarely reported. We report a patient who developed amnesia following an infarction of the left MTT that spared adjacent memory-related structures including the anterior thalamic nucleus. The patient s memory deficit was characterized by a severe anterograde encoding deficit and retrograde amnesia with a temporal gradient. In contrast, he did not show either frontal executive dysfunction or personality change that is frequently recognized in the anterior or medial thalamic lesion. We postulate that an amnesic syndrome can develop following discrete lesions of the MTT.
Subject(s)
Aged , Humans , Male , Amnesia/etiology , Cerebral Infarction/complications , Mammillary Bodies/physiopathology , Neuropsychological Tests , Thalamus/physiopathologyABSTRACT
Introducción. La corteza del lóbulo temporal medial estáintegrada por campos allocorticales que incluyen la formaciónhipocampal (giro dentado, hipocampo y complejo subicular) y cortezasextrahipocampales (entorrinal, perirrinal y parahipocampal).Ambas modalidades corticales desempeñan una función importanteen los procesos de memoria, y hay evidencia en humanos de quelesiones restringidas al hipocampo pueden provocar amnesia clínicamentesignificativa. Cuando las lesiones son más extensas, el cuadroclínico se complica con la manifestación de trastornos cognitivosrelacionados con la esfera visual, y se han comunicado algunosde estos casos como agnosias visuales. Aunque los estudios en animaleshan marcado la importancia de las cortezas extrahipocampalesen el proceso de reconocimiento de estímulos visuales, estehecho está escasamente demostrado en humanos. Caso clínico. Varónde 44 años que afirmaba haber perdido alrededor del 80% desu visión tras un accidente cerebrovascular. Los exámenes neurológicoy oftalmológico fueron normales, pero los estudios neuropsicológicosdemostraron dificultades en la discriminación de imágenessuperpuestas, apareamiento de caras y, principalmente, en pruebasde memoria visual inmediata y diferida; también se observó déficitde memoria anterógrada, y esto planteó la relación entre las manifestacionesvisuales y amnésicas. Las neuroimágenes mostraron lesiónde las cortezas extrahipocampales del lóbulo temporal medializquierdo. Conclusiones. Es posible que la exclusión funcional delhipocampo, por lesión de las cortezas entorrinal, perirrinal y parahipocampal,sea responsable de la sintomatología observada eneste paciente
Introduction. The cortex of medial temporal lobe is a group of different allocortical fields which included thehippocampal formation (dentate gyrus, hippocampus proper, and subicular complex) and extrahippocampal cortices (entorhinal,perirhinal, and parahippocampal). It is widely accepted that both of them play an important role in memory process.In humans, several reports indicates that damage to the hippocampus alone would lead to a clinically significant amnesia;when the injuries are more extensive others cognitive disorders, as those related to visual sphere, make worse the clinicpicture, and some of these cases were reported as associative visual agnosias. Nevertheless, although evidence from animalstudies points to the importance of the extrahippocampal medial temporal lobe cortices in order to recognise visual stimuli,such involvement has not been demonstrated in humans. Case report. A 44 year-old male who consulted us because they hadlost about of 80% of his vision after a stroke. Ophthalmological examination was entirely within normal limits, but neuropsychologicaltest put in evidence difficulties in the visuo-verbal naming, discrimination of superposed images, recognition offaces and, mainly, in the test of immediate and deferred visual memory. Anterograde memory impairment was also revealed.Magnetic resonance imaging showed a lesion of left entorhinal, perirhinal and parahippocampal cortices. Conclusions. Wesuggest, in relation to anatomical evidences, that isolation of hippocampus is responsible for symptomatollogy of our patient
Subject(s)
Male , Adult , Humans , Temporal Lobe/injuries , Temporal Lobe/physiopathology , Hippocampus/injuries , Hippocampus/physiopathology , Stroke/complications , Memory/physiology , Memory Disorders/etiology , Agnosia/etiology , Amnesia/etiology , Memory Disorders/physiopathology , Magnetic Resonance ImagingABSTRACT
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Background and objectives: Craniopharyngioma (CP) patients typically show good neuropsychiatric outcome following tumor resection. We present the case of a 51-year old woman who sustained damage to white matter pathways during surgery resulting in a disconnection of the Papez circuit (loss of bilateral mammillary bodies, columns of the fornix and mammillothalamic tracts). Methods and results: Neuropsychological evaluations were completed at 10 and 30 weeks post-operatively, and indicated both retrograde and severe anterograde amnesia, as well as persistent depression. At the second evaluation, most cognitive deficits had improved, but memory and mood deficits remained. Metamemory and priming remained intact. Conclusions: This case illustrates a profound neuropsychiatric morbidity associated with a surgery that is typically considered benign and confirms the well-known dissociation between explicit recollection of newly learned information and less conscious forms of learning and memory. This rare pathology provides further information regarding the role of the mammillary bodies in memory (AU)
Subject(s)
Humans , Mammillary Bodies/physiopathology , Memory/physiology , Amnesia/etiology , Neurosurgical Procedures/adverse effects , Craniopharyngioma/surgery , Depressive Disorder/physiopathology , Neuropsychological Tests/statistics & numerical dataABSTRACT
Entre los efectos adversos de la terapia electroconvulsiva (TEC), las quejas sobre disfunción mnésica son los más frecuentes y relevantes para los pacientes. Tras la TEC, la amnesia anterógrada y retrógrada son más determinantes para la memoria explícita y puede tener un efecto persistente sobre la episódica impersonal. La memoria implícita no suele resultar afectada. Los factores relacionados con más déficit son: TEC bilateral, dosis supraumbral elevada, onda sinusal, 3 tratamientos por semana, alteración cognitiva previa a la TEC y tiempo prolongado en recuperar la orientación tras ésta, agentes anestésicos y edad
One of the most frequent and important complaints made by patients about electroconvulsive therapy (ECT) is memory dysfunction. After ECT, anterograde and retrograde amnesia are more marked for explicit memory, and could have a lasting effect on impersonal episodic memory. Implicit memory is not usually affected. The factors related to severe dysfunction are: bilateral ECT, markedly suprathreshold stimulus, sinus wave, treatment three times per week, cognitive alteration before ECT and prolonged time to recovery of orientation after ECT, anesthetic agents, and age
Subject(s)
Humans , Electroconvulsive Therapy/adverse effects , Amnesia/etiology , Depressive Disorder/therapy , Age Factors , Amnesia/classification , Memory Disorders/classification , Memory/classification , Depressive Disorder, Major/therapyABSTRACT
Tradicionalmente, los trastornos disociativos, entre los que se encuentran la pseudocrisis y la amnesia generalizada, se han considerado diagnósticos de exclusión, y es en este grupo de trastornos donde resulta más manifiesto si cabe, la imprecisión de nuestro estado actual de conocimiento. Prueba de ello son las limitaciones de los sistemas nosológicos DSM-IV-TR y CIE 10, con ubicaciones diferentes para una misma entidad dependiendo de los criterios operativos empleados en su clasificación. El interés del caso que exponemos radica en su patoplastia y en su riqueza fenomenológica, en el que se observa una sucesión de complejos sintomáticos infrecuentes de manera independiente (pseudocrisis epilépticas y amnesia generalizada) y por tanto, excepcionales en su presentación simultánea. A partir de la descripción clínica del caso, se señalan los aspectos más relevantes de las entidades nosológicas mencionadas, y las inconsistencias de algunas de sus actuales asunciones
Traditionally, dissociative disorders, which include pseudoseizures and generalized amnesia, have been considered exclusion diagnosis and it is in this group of disorders where the present state of our knowledge is more confusing. The different location in nosologic systems DSM-IV-TR and ICD-10 for a same disorder depending on the used operating criteria in these systems is a proof of the previous comment. The interest of the case that we present consists in its pathoplasty and phenomenology, with a succession of infrequent and complex symptoms (pseudoseizures and generalized amnesia) which are unusual in their simultaneous appearance. From the clinical description of the case, we indicate the most relevant aspects of these disorders and the inconsistencies of some of their present assumptions
Subject(s)
Male , Adult , Humans , Dissociative Disorders/etiology , Dissociative Disorders/pathology , Amnesia/etiology , Amnesia/pathology , Memory/physiology , Amnesia/prevention & control , International Classification of Diseases/methodsABSTRACT
We report a 61-year-old right-handed man developing disturbance of memory after a discrete thalamic infarction. Neuropsychological assessment revealed deficits in memory with retrograde and anterograde components, especially for verbal material. Brain MRI showed a left anterior thalamic infarction with normal angiographic findings. Despite the small lesion in the thalamus, he showed prolonged memory disturbance and a Brain SPECT image revealed decreased uptake in the ipsilateral fronto-temporo-parietal cortex and contralateral cerebellum. This diaschisis, a phenomenon caused by disconnection of the neural pathway helped us to evaluate the functional state of the patient and this imaging technique was valuable for obtaining to get more information for the evaluation of the neurological state and neuronal connections. In conclusion our findings correspond well with the understanding of amnesia as a disconnection syndrome because of the evidence of diaschisis on the Brain SPECT image.
Subject(s)
Humans , Male , Amnesia/etiology , Brain/diagnostic imaging , Cerebellum/diagnostic imaging , Cerebral Infarction/complications , Middle Aged , Thalamic Diseases/complications , Tomography, Emission-Computed, Single-PhotonABSTRACT
El aprendizaje procedural y episódico es estudiado en un paciente masculino de 41 años, portador de un síndrome de Korsakoff crónico post-traumático y cuya tomografía computarizada mostró dilatación bilateral de los cuernos frontales y agrandamiento ventricular. Se realizaron 10 sesiones diarias, entrenando la lectura de logotomas y párrafos invertidos. Hubo una significativa disminución del número de errores en el tiempo de lectura, a pesar de no recordar los entrenamientos previos. Esto confirma la disociación entre el episodio olvidado y la preservación de la memoria procedural, disociación que podría ser útil en el entrenamiento conductual