Affiliations: Neurology Unit, S.Orsola-Malpighi University Hospital,
Bologna, Italy
Note: [] Corresponding author: Dr. Andrea Stracciari, Unità Operativa
di Neurologia, Policlinico S.Orsola-Malpighi, via Albertoni 15, 40138 Bologna,
Italy. Tel.: +39 051 6362643; Fax: +39 051 6362640; E-mail:
[email protected]
Abstract: We report the clinical findings and neuropsychological profiles of a
sample of patients exhibiting a focal retrograde amnesia (FRA) seen
consecutively during the period 1992–2007. The cohort comprised 13 patients,
five males, with a mean age of 30 years (range 16–49). They were given a
neurologic examination, psychiatric interview and formal neuropsychological
examination (all but one) during the amnesic phase, underwent neuroimaging, and
were followed up for six months to ten years. All presented with an acute
amnesia characterized by an impaired recollection of memories predating the
acute event, with spared or minimally and transiently affected anterograde
memory, thus consistent with FRA. The events triggering FRA varied widely: mild
to severe head injury, road accident without head injury, seizure, dissociative
fugue, BDZ overdose, posttraumatic headache, syncope, migraine attack, acute
distress. The neuropsychological hallmark of FRA was a selective or prominent
impairment of autobiographical memory. The defect was often so severe as to
cover most or all of the patients' lives and, in some cases, to erase the
knowledge of their own identity. Conventional neuroimaging (brain CT and MRI)
was unimpressive. Cerebral SPECT/PET disclosed unilateral frontal hypoperfusion
in three (two left). All but one patient fully recovered, time of recovery
ranging from three days to six months. FRA is a condition reflecting a block of
memory function triggered by heterogeneous events, including both physical and
psychic insults. Analogies shared with the more frequently encountered and
better known condition of transient global amnesia suggests common pathogenetic
mechanisms. A tentative nosographic classification of FRA is finally
offered.
