1/21. An atypical neuropsychological profile of a korsakoff syndrome patient throughout the follow-up.The basis of amnesia in alcoholic Wernicke-korsakoff syndrome (WKS) has been generally associated with diencephalic lesions and more specifically with lesions of the anterior thalamic nuclei. These brain structures are considered to be involved in encoding/consolidation processes of episodic memory. However, frontal lobe damage responsible for executive function deficits has also been documented. The present report details the nature and extent of amnesia in an alcoholic patients with WKS and which appears to be mainly due to frontal lobe (executive) deficits.- - - - - - - - - - ranking = 1keywords = memory (Clic here for more details about this article) |
2/21. Memory disorder in Korsakoff's psychosis: a neuropathological and neuropsychological investigation of two cases.Neuropathological findings in the brains of two alcoholic patients with Korsakoff's psychosis are reported. Their memory defects had been studied in detail quantitatively over a period of nine years in one case and three years in the other, relevant details of which are presented. Both patients had had a relatively pure long-term memory impairment in the absence of other cognitive deficits and in the absence of a short-term memory impairment. Their retrograde amnesia for public events and famous faces had been measured and found to have extended backwards over at least twenty-five years. There was severe impairment in anterograde recognition memory for both verbal and non-verbal material. On a newly prepared memory quotient battery both patients had scored well below the bottom of the normal scale (less than 60, where 100 is the mean with a standard deviation of /- 15). Both patients had also shown the characteristic differential improvement in retention when tested by cued recall and also the characteristic 'prior learning effect', i.e. normal retention of one list of words when tested by cued recall but impaired retention of a second list sharing the same cues as the first list. There had been a slight but significant deterioration in intelligence in one of the patients in the two years prior to his death, although his IQ still fell within the normal range. The other patient remained undeteriorated until his death, and his IQ also was close to an estimated measure of his premorbid IQ. In the brains of both patients there was marked gliosis, shrinkage and discolouration bilaterally in the medial nuclei of the mammillary bodies. In addition there was a thin band of gliosis bilaterally between the wall of the third ventricle and the medial dorsal nucleus, the rostral limit lying anterior to the medial dorsal nucleus. In the patient with no intellectual deterioration these were the only pathological changes that were seen. In neither patient was there evident local loss of nerve cells, gliosis or any other qualitative evidence of abnormality in the hippocampi, the white matter of the temporal lobes or the greater part of the medial dorsal nuclei, although it is difficult to be certain whether there was any overlap between the band of gliosis and the most medial region of the medial dorsal nueleus and other adjacent thalamic nuclei. In the other patient there was also a small zone of softening in the cerebellum and an increase in astrocytes in other regions of the cerebral hemispheres, including the basal ganglia, amygdala, and brain-stem, but without noticeable loss of cells. The question of the minimal lesion for the alcoholic Korsakoff amnesic state, and some aspects of the related anatomy, is discussed in the context of other reports in the literature which are, however, difficult to assess in the absence of details of the specificity, severity and character of the memory disorders.- - - - - - - - - - ranking = 51.480825123177keywords = memory disorder, memory (Clic here for more details about this article) |
3/21. The localization of memory.MRI showed severe lesions, thought to be specific for the Wernicke-korsakoff syndrome, in an alcohol dependent patient with an excellent memory. The morphological abnormalities thought to be typical of Wernicke-korsakoff syndrome might be features of chronic alcoholism and malnutrition. This contention has important implications for the localization of memory functions. Recent literature on the anatomical basis and mechanism of memory is reviewed. Memory probably resides in multifocal neural networks rather than in specific anatomical sites.- - - - - - - - - - ranking = 7keywords = memory (Clic here for more details about this article) |
4/21. Creutzfeldt-Jakob disease presenting as Wernicke-korsakoff syndrome.A 47-year-old man began to suffer from progressive truncal ataxia and mental alterations typical of Wernicke-korsakoff syndrome. He showed confusional state, hallucinations, delirium of jealousy and a serious impairment of recent memory. The symptomatology lasted 13 months, but only in the last weeks was it complicated by myoclonias. Triphasic pseudoperiodic sharp-waves characterized the EEG-recordings only in the final stage. Macroscopic examination of the brain showed marked atrophy of the mammillary bodies and superior vermis. However, the histological features were consistent with Creutzfeldt-Jakob disease (CJD) with focal accentuation of the changes in the latter structures. This case supports the hypothesis that CJD-changes begin focally in the CNS and, subsequently, spread along neuronal pathways, probably via central axons. Only in the final stage does the pathological process involve most parts of the gray matter. A focal accentuation of the CJD process in the cerebello-mammillo-thalamic system caused in this case a Wernicke-Korsakoff-like syndrome.- - - - - - - - - - ranking = 1keywords = memory (Clic here for more details about this article) |
5/21. Memory for what it is and memory for what it means: a single case of Korsakoff's amnesia.A single case of Korsakoff's syndrome, showing classic circumscribed amnesia on traditional neuropsychological tests, performed a number of learning tasks previously used in primates to demonstrate the different anatomical basis of memory systems used to learn about the properties of objects or to learn about rules of responding. The patient (CJ) performed in a manner very similar to lesioned monkeys in that he could learn evaluative tasks (e.g. a red object is nice), but not rule based tasks (e.g. a red object means go left). In consequence CJ learned an object discrimination task in a manner qualitatively different from a group of non-amnesic controls. Although he could not learn rule based tasks, CJ could perform them once he had been given the rule. Detailed analysis of learning showed that CJ could choose the object he had chosen previously, but could not say where it had been or whether he had been rewarded. Furthermore he could recognise a word as familiar, while not remembering its source. We propose that he has a specific impairment in a memory system concerned with the representation of the signification of objects in particular contexts, while representation of the properties of objects remains intact.- - - - - - - - - - ranking = 6keywords = memory (Clic here for more details about this article) |
6/21. Wernicke-korsakoff syndrome of nonalcoholic origin.We describe a patient who developed a severe loss of memory following intravenous feeding and intestinal surgery. The pattern of both anterograde and retrograde memory impairment and frontal pathology is shown to be comparable with that observed in patients with Wernicke-korsakoff syndrome of an alcoholic etiology. The data strengthen the view that the essential characteristics of the Wernicke-korsakoff syndrome are not dependent on a prior history of chronic alcoholism. Implications of these data for the interpretation of alcoholic Wernicke-korsakoff syndrome are considered.- - - - - - - - - - ranking = 2keywords = memory (Clic here for more details about this article) |
7/21. Korsakoff's syndrome as the initial presentation of multiple sclerosis.A 37-year-old man presented with an acute amnestic syndrome of Korsakoff's type and an upper brain-stem oculomotor syndrome. After a moderate improvement with steroid therapy, he developed progressive behavioural changes due to a frontal lobe syndrome, in addition to motor and visual impairment. Memory performance was investigated on several occasions during an 11-year follow-up. diagnosis of laboratory-supported definite multiple sclerosis was established and magnetic resonance imaging showed disseminated white matter lesions, especially in both medial temporal lobes. No other cause than multiple sclerosis was found for the amnestic syndrome. Among the rare cases of Korsakoff's syndrome in the course of multiple sclerosis, this is to our knowledge the first case in which a memory deficit was the initial manifestation of the disease.- - - - - - - - - - ranking = 1keywords = memory (Clic here for more details about this article) |
8/21. Wernicke's encephalopathy manifested as Korsakoff's syndrome in a patient with promyelocytic leukemia.A case of Wernicke's encephalopathy associated with promyelocytic leukemia found at autopsy is reported. The patient was 30 years old and was undergoing chemotherapeutic treatment when she had a memory deficit for recent events (Korsakoff's syndrome) which persisted for 6 months, until death. The neuropathologic examination showed typical, old lesions that characterize Wernicke's encephalopathy, but only in the mamillary bodies. This case is compared with three other cases of Wernicke's encephalopathy associated with leukemia previously described in the literature. comment is made on the cliniconeuropathologic picture and risk factors in leukemic patients that may favor the appearance of Wernicke's encephalopathy.- - - - - - - - - - ranking = 1keywords = memory (Clic here for more details about this article) |
9/21. Comparison of a system of staff prompting with a programmable electronic diary in a patient with Korsakoff's syndrome.The effect of a programmable electronic diary was compared with a system of staff prompting on the attendance at occupational therapy groups of a patient with Korsakoff's syndrome. Throughout the baseline period, the subject did not attend any groups. With the help of verbal prompting and other staff intervention, his attendance at groups increased significantly. By the fourteeth week he was attending all groups without verbal prompting apparently by using other environmental cues. The introduction of the electronic diary at this point was not found to increase the subject's attendance at groups further or to reduce the need for verbal prompting presumably due to a "ceiling effect". These findings suggest that despite severe memory impairment, the patient with Korsakoff's syndrome is able to learn new information. The potential of the electronic diary for reducing staff input and its use in a less predictable setting need to be evaluated further.- - - - - - - - - - ranking = 1keywords = memory (Clic here for more details about this article) |
10/21. Characteristics of the memory loss of a patient with Wernicke-Korsakoff's syndrome without alcoholism.The memory loss in alcoholic Wernicke-korsakoff syndrome has been well characterized. However, it has been suggested that some of the neuropsychological defects seen in these patients are due to frontal lobe dysfunction resulting from chronic alcohol abuse. The present report details the nature and extent of the amnesia in a Wernicke-Korsakoff patient who did not have a history of alcoholism. In spite of her normal performance on measures of frontal lobe function, this patient showed many characteristics similar to those seen in alcoholic Wernicke-korsakoff syndrome including a graded loss of remote memories and abnormal semantic information processing. Thus, the extent of the "core" features of this amnesic syndrome may be greater than was previously thought.- - - - - - - - - - ranking = 7.2981958979478keywords = memory, memory loss (Clic here for more details about this article) |
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