Long-Term Neuropsychological, Neuroanatomical, and Life Outcome in Hippocampal Amnesia

Abstract

Focal bilateral hippocampal damage typically causes severe and selective amnesia for new declarative information (facts and events), a cognitive deficit that greatly impacts the ability to live a normal, fully independent life. We describe the case of 1846, a 48-year-old woman with profound hippocampal amnesia following status epilepticus and an associated anoxic episode at age 30. Patient 1846 has undergone extensive neuropsychological testing on many occasions over the 18 years since her injury, and we present data indicating that her memory impairment has remained severe and stable during that time. New, high-resolution, structural MRI studies of 1846's brain reveal substantial bilateral hippocampal atrophy resembling that of other well-known amnesic patients. In spite of severe amnesia 1846 lives a full and mostly independent adult life, facilitated by an extensive social support network of family and friends. Her case provides an example of a rare and unlikely positive outcome in the face of severe memory problems.

Keywords:

• Amnesia
• Hippocampus
• Memory
• Medial temporal lobe
• Anoxia

Acknowledgments

This work was supported by the following funding sources: NINDS P50 NS19632 (DT). The authors would like to express their gratitude to 1846, her husband, and her parents for consenting to participate in our research and for the interviews that informed this case report. The authors would also like to thank Dr. Steven W. Anderson, Dr. Sara Cavaco, Kenneth Manzel, and Joel Bruss for their contributions to this report.