Download Consciousness and Sleep This week you were introduced to

Consciousness and Sleep
This week you were introduced to different but related topics, of sleep and consciousness. For
this discussion, you will focus on a disorder of one of these topics.
Option A: Identify a peer-reviewed, research study that was published within the last five years,
and focuses on elucidating the cause or a new treatment for one of the disorders of consciousness
covered this week. Be sure to include a discussion of theories surrounding this disorder and how
this research interacts with current theories. Your initial post should be a minimum of 250 words.
Option B: Identify a peer-reviewed, research study published within the last five years, and
focuses on elucidating the cause or a new treatment for one of the disorders of sleep covered this
week. Be sure to include a discussion of theories surrounding this disorder and how this research
interacts with current theories. Your initial post should be a minimum of 250 words.
OPTION A
Anterograde amnesia refers to loss of memory for events after an incident – often such cases are
examples of what are known as pure amnesiacs. Therefore, a person can’t store new information
in their short term memory.
Patients with anterograde amnesia quite often show normal memory for events prior to the
incident responsible for the memory deficit but have severely impaired ability to recall
information about events occurring after the incident. Whereas with retrograde amnesia there is
almost always a gradual restoration of most of the lost information, with anterograde amnesia
there is quite often no such recovery and patients are left with a permanent and debilitating
condition. The case which led to the discovery of the condition of anterograde amnesia is that of
H.M. (Milner et al 1968).
In this case study a 65-year-old Caucasian woman presented to the emergency department with
a chief complaint of confusion and forgetfulness. According to her husband, suddenly sometime
around mid-afternoon, he found her confused, disoriented, and asking ‘bizarre questions’. The
patient stated that she was in a ‘dream-like’ state where she was in the company of President
Obama and her deceased mother. She remained confused and kept asking repetitive questions.
There was no history of any prior similar episodes. She complained of a minimal frontal
headache that was pulsating in quality, but there were no associated light aversion, visual auras,
nausea or vomiting, nor did she have any past history of migraines. There was no history of any
seizure disorder, nor were there any complaints of strange smells, tastes, epigastric rising, or
sensations of depersonalization. There were no complaints of any numbness, weakness, tingling,
vertigo, slurred speech, double vision, lapses of consciousness, chest pain, shortness of breath,
fevers, chills, nausea, vomiting, abdominal pain, or changes in bowel or urinary function.
The patient's past medical history was significant only for well-controlled hypertension and
hypercholesterolemia.
General physical examination revealed a blood pressure of 176/84 mm Hg, a heart rate of 79
beats per minute, and a temperature of 98.5 °F. She appeared well-developed and well-nourished
without any distress. Her lungs were clear to auscultation bilaterally, and her breathing was
without retractions or accessory muscle use. Neurological examination demonstrated that her
mental status was quite intact. She was awake, alert, and oriented to person, place, and time. She
kept asking repetitive questions such as ‘what happened?’ Long-term memory was intact (she
was able to state her birth date) and she was aware of current events, but short-term memory was
impaired. No active hallucinations or delusions were noted. She was easily able to recognize
family members. Her speech was fluent without evidence of aphasia. Cranial nerve examination
showed intact visual fields, papillary symmetry and appropriate light reaction, and no evidence
of papilledema. All r eye muscles were full and intact bilaterally. No nystagmus was noted.
Treatment is generally not required, and the condition usually does not recur. Clinicians,
including neurologists, internists, family practice physicians, and psychiatrists, need awareness
of this condition. TGA is an interesting entity of reversible anterograde amnesia associated with
repetitive questioning that occurs with an unclear etiology in middle-aged and elderly
individuals.
Although we can not exclude an ischemic origin or transient venous congestion, we postulate
that the acute pain of our patient’s aortic dissection triggered a stress reaction, responsible for
his transient global amnesia. We were fortunate that our patient’s colleague was able to
describe circumstances of onset that indicated an acute disorder requiring urgent
treatment. (Bonnet, 2007)
Recent evidence suggests that amnesic patients do not benefit normally from an exact perceptual
match of stimuli between study and text. The purpose that this impairment may reflect one
manifestation of a more general deficit in associative binding of information across different
brain subsystems. This idea helps to clarify the distinction between implicit and explicit memory,
and suggests that studies of implicit memory can help to elucidate the functional deficits in
amnesia.
Freud looked upon amnesia as a symptom resulting from repression, as a phenomenon which
could be circumscribed but which was not a defense mechanism. He compared infantile amnesia
to hysterical amnesia, of which in his view it was the forerunner, both forms being connected
with the child's sexuality and Oedipus complex. Amnesia concealed mnemic traces of traumatic
events and, more generally, contents of the unconscious
It is now becoming apparent that while anterograde amnesia devastates memory for facts or
events, it may spare memory for skills or habits. Thus, an individual with amnesia can be taught
a new skill, such as how to play a game or how to write backwards. The next day, the amnesic
individual will claim to have no memory of the prior session, but when asked to try executing the
skill, can often perform quite well - indicating that some memories have been formed. It is an
important area of current research to document exactly which kinds of memory can be formed in
amnesia, and how this may be used to help rehabilitate amnesic individuals.
Bonnet, P. P. (2007). puzzling case of transient global amnesia. Lancet, , 364.