1/12. Use of antecedent control to improve the outcome of rehabilitation for a client with frontal lobe injury and intolerance for auditory and tactile stimuli.KM, a single 23-year-old male, sustained a severe traumatic brain injury in a motor vehicle accident. Aggressive and uncooperative behaviour, resulting from the client's cognitive deficits and hypersensitivity to stimuli, made him unmanageable in a subacute rehabilitation setting. Minimizing sources of agitation reduced the client's outbursts and facilitated the completion of functional tasks, such as bathing and dressing. Modifying his environment also increased the client's participation in social and leisure activities. These changes improved the outcome of the client's rehabilitation.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/12. Executive amnesia in a patient with pre-frontal damage due to a gunshot wound.This paper reports the case of a young patient with extensive pre-frontal damage in whom we tested the hypothesis that intensive training improves executive performance as assessed by the wisconsin Card Sorting Test (WCST). As long as her declarative memory, complex perceptual abilities and global cognitive status were spared, we surmised that any deficit in executive learning would have occurred in relative isolation. We showed that her abnormal performance on the WCST, both on the standard as well as on the post-instruction condition, was due to an impairment of shifting attention across perceptual dimensions (extra-dimensional). In contrast, her ability to shift attention within perceptual categories (intra-dimensional) was spared, as were her declarative memory, object and visuospatial perception, oral language comprehension and praxis (ideomotor, tool use and constructional). This case supports the hypothesis that executive amnesia is a type of amnesic disorder distinct from the classic amnesic syndrome due to mamillo-temporomedial damage. As such, it is probably closely related to procedural learning and may depend on the same fronto-subcortical loops that mediate the actual execution of behaviour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
3/12. Preserved memory traces within diencephalic amnesia.A male patient with bilateral thalamic lesions (medio-ventral nuclei) was investigated. Despite explicit memory impairments his lexical ability was normal. We recorded magnetic field changes (magnetoencephalography, MEG) during the performance of an animate/inanimate discrimination task in which some words where repeated after long delays. Normally, repeated items are classified significantly faster than their first presentations which is accomplished by an unconscious process called priming. The patient did not show any behavioural evidence of priming but the physiological data indicated preservation of this robust form of memory. brain activation associated with repetitions was attenuated at early stages. The activity difference was posteriorly distributed which is consistent with previous reports about repetition priming. The present study indicated that the bilateral thalamic lesions of our patient disconnected the information processing stream between the primed information and the behavioural response.- - - - - - - - - - ranking = 2keywords = behaviour (Clic here for more details about this article) |
4/12. bupropion-induced somnambulism.Whereas there are some case reports of bupropion-induced vivid dreaming and nightmares, until now it has not been associated with somnambulism. A case is reported of a patient treated with bupropion as a smoking cessation medication, who developed somnambulism during nicotine withdrawal. Furthermore, the sleepwalking episodes were associated with eating behaviour. amnesia was reported for all episodes. As, on one hand,bupropion is a noradrenergic and dopaminergic drug and nicotine withdrawal, on the other hand, is associated with alterations in monoaminergic functions, an interaction at the level of these neurotransmitters is suggested as the underlying mechanism.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
5/12. Pathologically proven frontotemporal dementia presenting with severe amnesia.Early and severe memory impairment is generally held to be an exclusion criterion for the clinical diagnosis of frontotemporal dementia (FTD). However, clinical experience suggests that some patients with otherwise typical FTD can be amnesic from presentation, or even present solely with amnesia. A review of severe amnesia at presentation in patients with pathologically proven FTD is therefore warranted. The present study examined the records of all patients in the joint Cambridge-Sydney neuropathological series of patients with dementia and a pathological diagnosis of FTD to identify those for whom memory complaints were dominant at presentation. Eight of 71 patients met these criteria. For two patients, memory loss was the only complaint; for one patient, memory loss was accompanied by personality change; for two patients, memory loss was accompanied by prominent dysexecutive symptoms; and for three patients, memory loss was accompanied by apathy but no other behavioural changes. In seven patients local specialist teams initially diagnosed Alzheimer's disease; four patients entered anticholinesterase drug trials. All eight later developed behavioural features: in four, the diagnosis was revised to FTD, while in four the diagnosis of FTD was made only on neuropathological examination after death. In conclusion, severe amnesia at presentation in FTD is commoner than previously thought and the clinical consensus criteria for the diagnosis of FTD may need to be revised. The underlying basis of the memory impairments in patients with FTD may be heterogeneous, with different explanations in different subgroups.- - - - - - - - - - ranking = 2keywords = behaviour (Clic here for more details about this article) |
6/12. triazolam-induced nocturnal bingeing with amnesia.A combination of behavioural and cognitive adverse effects is illustrated in this case report of a recurrent triazolam-induced eating disorder. The co-occurrence of bingeing, irritability and anterograde amnesia is suggestive of a drug-induced kleine-levin syndrome.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
7/12. Observations during transient global amnesia. A behavioural and neuropsychological study of five cases.The clinical and behavioural features of 5 patients examined during transient global amnesia (TGA) are described. All underwent extensive neuropsychological testing during and sequentially after the attack. Our results show that in TGA there is a characteristic neuropsychological deficit which parallels that in the permanent amnesic syndrome. personality, complex cognition and problem solving, semantic knowledge, language and visuospatial function remained intact. Immediate memory was preserved. Longer-term verbal and nonverbal memory was severely disrupted in all cases. In contrast, the extent of retrograde amnesia was highly variable. A famous faces test showed an extensive deficit in 3 cases, with improvement in all cases following the attack. Analysis of group data confirmed the presence of a reversible temporal gradient, in that more distant memories were relatively spared. On a famous events test, recognition was normal across all decades, but dating of events from the 1960s and 1970s was consistently impaired. The Crovitz test of remote personal episodic memory was given to 3 subjects; all showed impaired uncued autobiographical memory and in contrast to normal controls, had a virtual absence of recent memories. During recovery from TGA there was progressive shrinkage of retrograde amnesia but a permanent short retrograde gap of around 1 h remained in all cases. Although subjectively normal within 24 h, all cases demonstrated persisting impairment of new learning for at least a week post-TGA. The relevance of the neuropsychological data to theories concerning the amnesic syndrome is discussed. We postulate a temporary deficit in retrieval of remote memories which appears to be dissociable from the anterograde amnesia.- - - - - - - - - - ranking = 5keywords = behaviour (Clic here for more details about this article) |
8/12. Amnesic syndromes after surgery of anterior communicating artery aneurysms.Five patients had severe generalized disorder of memory, which lasted for several months after anterior communicating artery aneurysm surgery. Two of them had no signs of frontal lobe lesions. They were confused for not more than four days after surgery. One of them performed normally on the non-memory tests and short-term memory tests. cues did not substantially improve his poor memory performance. The other patient had similar test results, but he had poor imagination in an inkblot perception test. Three patients had frontal lobe lesions. Two of them were restless, confused and confabulating, with one showing apathetic and stereotyped behaviour for more than a month after surgery. On the memory tests they showed disinhibition of irrelevant associations or deficient initiative. Cueing markedly improved their poor retrieval. These defects seem to be associated with frontal lobe lesions and can affect memory but are not obligatory features of amnesia.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
9/12. From experiences of medial amygdalotomy on epileptics.This paper does not present any new cases. From the long-term follow-up study of the cases operated by the stereotaxic medial amygdalotomy, the progressive worsening in clinical pictures of the chronic epileptics, such as changes of pattern of seizures, aggravation of seizure tendency and of emotional and behaviour problems, were found to be parallelly improved. The reason of such beneficial changes is discussed and the possible participation of the limbic structures is suggested.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
10/12. Transient global amnesia in a young child.Unprovoked and unexplained sudden loss of memory and inappropriate behaviour in a 5 year old child is described as fitting into the clinical picture of 'transient global amnesia'. The likely pathophysiology of this condition is discussed with some support for Fisher's suggestion of 'hippocampal-fornical' dysfunction.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
| | Next -> |