Download Types of amnesia

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MINISTRY OF HEALTH OF UKRAINE
BUKOVYNIAN STATE MEDICAL UNIVERSITY
“Approved”
on the methodical meeting
of the Department of neurology, psychiatry
and medical psychology nm. S.M.Savenko
“____” ___________ 2009 (Report № __).
Chief of the Department
_______________________
Professor V.M. Pashkovsky
METHODICAL INSTRUCTION
for 4-th year students of medical faculty №2
(the speciality “medical affair”)
for independent work during preparing to practical class
Theme 5: MEMORY DISORDERS
MODULE 1. GENERAL QUESTIONS OF PSYCHIATRY AND NARCOLOGY.
GENERAL PSYCHOPATHOLOGY
TOPICAL MODULE 2. GENERAL PSYCHOPATHOLOGY
Сhernivtsi, 2009
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1. Actuality Aim
Memory is the ability of an organism to store, retain, and subsequently recall
information. Reflection of separate properties of objects and phenomena of the outer
world and internal state of organism, that directly influence on analyzers (feeling) is
difficult psychical activity in the process of which a man cognizes surrounding the
world and internal state of organism. The result of operating on the analyzers of
objective reality is synthesized with the pas practical experience in one whole.
Knowledge of the state of memory of the patients are important for a doctor on
all stages of diagnosis process and treatment.
2. Educational purpose
2.1. A student must know:
1. Classification of disorders of memory.
2. Determination and clinical displays of amnesia.
3. Determination and clinical displays of paramnesias.
4. Objective signs of memory disorders.
5. Psychopathological syndrome of memory disorders.
6. Diagnostic value of disorders of memory.
7. Peculiarities of the investigation of memory.
2.2. A student must be able:
1. To determine the rightness of orientation of patients in an own person and
in an environment.
2. To present memory disorders.
3. To investigate the state of memory.
4. To find out the objective signs of memory disorders.
5. To diagnose psychopathological syndrome of memory disorders.
2.3. To seize practical skills:
1. Asked the anamnesis at patient with memory disorders.
2. Diagnosing memory disorders.
3. Conducting of differential diagnosis between different type of amnesias and
paramnesias.
4. Diagnosing pathopsychological syndrom of memory disorders.
3. Educate purpose.
On practical employment attention of students is concentrated on knowledge
of pathology of bases of conformity to the law of cognitive activity of patient, that
allows a doctor to analyse diagnostic and medical processes, draw conclusions and
give the correct estimation of the state of feelings and perception sick for giving him
necessary medical assistance.
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4. Intersubject integration (base level of preparation).
Names of previous disciplines
1. Normal physiology
2. Medical psychology
Skills are got
1. Physiology of HNS
2. Classification of memory.
5. Content of the theme.
The basic stage foresees conducting with the students of educational activity and
determination of memory disorders.
Amnesia is a condition in which memory is disturbed. The causes of amnesia
are organic or functional. Organic causes include damage to the brain, through
trauma or disease, or use of certain (generally sedative) drugs. Functional causes are
psychological factors, such as defense mechanisms. Hysterical post-traumatic
amnesia is an example of this. Amnesia may also be spontaneous, in the case of
transient global amnesia. This global type of amnesia is more common in middleaged to elderly people, particularly males, and usually lasts less than 24 hours.
Types of amnesia

In anterograde amnesia, new events contained in the immediate memory are
not transferred to the permanent as long-term memory, so the sufferer will not
be able to remember anything that occurs after the onset of this type of amnesia
for more than a brief period following the event. The complement of this is
retrograde amnesia, where someone will have impaired recall of events that
occurred prior to the onset of the amnesia. The terms are used to categorise
patterns of symptoms, rather than to indicate a particular cause or etiology.
Both categories of amnesia can occur together in the same patient, and
commonly result from drug effects or damage to the brain regions most closely
associated with episodic/declarative memory: the medial temporal lobes and
especially the hippocampus.

Retrograde Amnesia is the inability to recall some memory or memories of
the past, beyond ordinary forgetfulness. An example of mixed retrograde and
anterograde amnesia may be a motorcyclist unable to recall driving his
motorbike prior to his head injury (retrograde amnesia), nor can he recall the
hospital ward where he is told he had conversations with family over the next
two days (anterograde amnesia).

Traumatic amnesia is generally due to a head injury (fall, knock on the head).
Traumatic amnesia is often transient, but may be permanent of either
anterograde, retrograde or mixed type. The extent of the period covered by the
amnesia is related to the degree of injury and may give an indication of the
prognosis for recovery of other functions. Mild trauma, such as a car accident
that could result in no more than mild whiplash, might cause the occupant of a
car to have no memory of the moments just before the accident due to a brief
interruption in the short/long-term memory transfer mechanism.
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
Long-term alcoholism or malnutrition can cause a type of memory loss known
as Korsakoff's syndrome. This is caused by brain damage due to a Vitamin B1
deficiency and will be progressive if alcohol intake and nutrition pattern are
not modified. Other neurological problems are likely to be present in
combination with this type of Amnesia. Korsakoff's syndrome is also known to
be connected with confabulation.

Short-term memory loss is a common symptom of Alzheimer's disease and
other forms of dementia.

Psychogenic amnesia results from a psychological cause as opposed to direct
damage to the brain caused by head injury, physical trauma or disease, which is
known as organic amnesia. This can include:

Dissociative amnesia is used to refer to inability to recall information,
usually about stressful or traumatic events in persons' lives, such as a
violent attack or rape. The memory is stored in long term memory, but
access to it is impaired because of psychological defense mechanisms.
Persons retain the capacity to learn new information and there may be
some later partial or complete recovery of memory. This contrasts with
e.g. anterograde amnesia caused by amnestics such as benzodiazepines
or alcohol, where an experience was prevented from being transferred
from temporary to permanent memory storage: it will never be
recovered, because it was never stored in the first instance.

Lacunar amnesia is the loss of memory about one specific event.

Childhood amnesia (also known as Infantile amnesia) is the common
inability to remember events from one's own childhood. Whilst Sigmund
Freud attributed this to sexual repression, others have theorised that this
may be due to language development or immature parts of the brain.
This is often exploited by the use of false memories in child abuse cases.

Global Amnesia is total memory loss. This may be a defence mechanism
which occurs after a traumatic event. Post-traumatic stress disorder can also
involve the spontaneous, vivid retrieval of unwanted traumatic memories.
(flash-backs)

Source amnesia is a memory disorder in which someone can recall certain
information, but they do not know where or how they obtained the information.
Students independently under the direction of teacher inspect mentally
patients with different memory disorders.
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5.1. Questions of controls:
1. Classification of disorders of memory.
2. Determination and clinical displays of amnesia.
3. Determination and clinical displays of paramnesias.
4. Objective signs of memory disorders.
5. Psychopathological syndrome of memory disorders.
6. Diagnostic value of disorders of memory.
7. Peculiarities of the investigation of memory.
5.
Tasks for self-control.
1. The patient was brought to the reception department of a psychiatric hospital by
policemen. At the reception department the patient is tense and angry. He states that
his neighbor has established in his flat an apparatus, with which he records all the
patient's thoughts and inserts his own thoughts into his head. Sometimes with the help
of special equipment the neighbor broadcasts pro-grams, in which offends the patient
in different ways. Recently the neighbor made the patient walk in the wrong
direction, use obscene language in public, and produced artificial cheerfulness in him.
The patient attacked his neighbor and tried to stab him with a knife.
Name the probable syndrome:
A. Fregoly syndrome
B. Da Casta's syndrome
C. Cotard's syndrome
D. Syndrome of intermetamorphose
E. Clerambault-Kandinsky syndrome
2. A 15-year-old teenager girl during last 4 or 5 months began to pay excessive
attention to her appearance. For hours she looks at herself in the mirror, finds some
defects in her face, which make it look "horrible" (states that her nose is crooked and
her ears are too protruding). Thinks that everybody laughs at her. It is impossible to
persuade her that she isn't right. She consulted a cosmetologist and asked him to
make a plastic operation on her face.
Name the probable syndrome:
A. Hypochondriac syndrome
B. Cotard's syndrome
C. Dysmorphomanic syndrome
D. Fregoly
E. Metamorphopsia
7. Tests for self-control.
1. A memory disorder in which someone can recall certain information, but they
do not know where or how they obtained the information, named:
*A. Retrograde amnesia
B. Gypomnezia.
C. Anterograde amnesia.
D. Traumatic amnesia
E. Lacunar amnesia.
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2. A patient actively casts aside ideas about illness and her consequences are
possible, estimates the displays of illness as not "serious feelings", that is why
renounces an inspection and treatment or limited to "self-treatment". Which type
of reacting on illness?
A. Egocentric.
B. Harmonious.
C. Apathetical.
D. Euphoric.
*E. Anosognosia.
3. Ability to understand, recall, mobilize, and constructively integrate previous
learning in meeting new situations named:
A. Feeling.
B. Perception.
C. Memory.
*D. Intellect.
E. Thought.
4. Misinterpretation perception of a true sensation of surrounding objects and
phenomena of the real world name:
*A. Illusions.
B. Hallucinations.
C. Delirium.
D. Depersonalization.
E. All answers are true.
5. A sensory perception experienced in the absence of an external stimulus is
named:
A. Illusions.
*B. Hallucinations.
C. Delirium.
D. Depersonalization.
E. All answers are true.
6. A psychical process by which a man represents past experience and real reality
is named
A. Thoughts.
B. Perception.
C. Attention.
*D. Memory.
E. Emotions.
7. False belief, based on incorrect experience about external reality, cannot be
corrected named:
*A. Delusion.
B. Neologism.
C. Verbigeration.
D. Derailment.
E. Blocking.
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Literature
1. Clinical Psychiatry from Synopsis of Psychiatry by H.I.Kaplan, B.J.Sadock. –
New York: Williams @ Wilkins. – 1997.
2. Psychiatry. Course of lectures. – Odessa: The Odessa State Medical University.
– 2005. – 336 p.
3. Lectures.
4. Internet resource.
5. Менделевич В.Д. Психиатрическая пропедевтика. – М.: Медицина, 1997.
6. Морозов Т.В., Шумский Н.Г. Введение в клиническую психиатрию. –
Н.Новгород: Изд-во НГМА, 1998.
7. Попов Ю.В., Вид В.Д. Современная клиническая психиатрия. – М., 1997.
8. Сонник Г.Т. Психіатрія: Підручник / Г.Т.Сонник, О.К.Напрєєнко,
А.М.Скрипніков. – К.: Здоров’я, 2006.
Prepared by assistant
S.D.Savka