边缘脑炎致局灶性逆行性遗忘1例

Nobuhiro Takahashi, M. Kawamura, Naoki Tanihara, Mamiko Sato, Yasutaka Kobayashi
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引用次数: 0

摘要

本病例研究涉及与边缘脑炎相关的情景性记忆障碍或局灶性逆行性遗忘。该患者是一名60多岁的右撇子,因边缘脑炎而患上局灶性逆行性健忘症。右侧内侧颞叶MRI显示异常信号。脑炎发作后立即出现精神症状,包括意识受损、定向障碍、幻觉和妄想;不过,经过治疗,他的病情有所好转。转到康复医院后,进行了各种神经心理测试,但在智力功能、注意力、记忆力或记忆力方面没有观察到明显的功能下降。然而,患者在边缘脑炎发病前4 - 5年表现出与自传体记忆和事件记忆相关的损伤。基于这些观察,我们认为患者表现出局灶性逆行性失忆,原因是边缘脑炎。尽管表现出逆行性健忘症,但他在病房的日常生活没有任何困难。此外,出院后,顺利恢复工作是可能的。这个案例表明,即使在表现出逆行性失忆症之后,如果其持续时间相对较短,身体功能和其他高级大脑功能得以维持,社会康复——包括恢复工作——是可行的。
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Case Study on Focal Retrograde Amnesia due to Limbic Encephalitis
This case study addresses episodic memory impairment or focal retrograde amnesia related to limbic encephalitis. The patient in question was a right-handed man in his 60s who developed focal retrograde amnesia due to limbic encephalitis. An abnormal MRI signal was observed in the right medial temporal lobe. Immediately after the encephalitis onset, mental symptoms—including impaired consciousness, disorientation, hallucinations, and delusions—appeared; however, his condition improved with medical treatment. After transfer to a convalescent and rehabilitation hospital, various neuropsychological tests were conducted but no apparent functional decline was observed in intellectual function, attention, memorization, or retention. However, the patient exhibited impairments related to autobiographical memory and memory of events 4 - 5 years before the onset of limbic encephalitis. Based on these observations, the patient was considered to exhibit focal retrograde amnesia due to limbic encephalitis. Despite exhibiting retrograde amnesia, he had no difficulty in his daily life in the ward. Moreover, after discharge from hospital, smooth work reinstatement was possible. This case demonstrates that, even after exhibiting retrograde amnesia, if its duration is relatively short and physical function and other higher-order brain functions are sustained, social rehabilitation—including work reinstatement—is feasible.
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