Journal

The Japanese journal of neuropsychology

[Vol.17 No.2 contents]
Japanese/English

Full Text of this Article
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ArticleTitle Neuropsychological and MRI volumetric study in a patient with severe persistent amnesia following herpes simplex encephalitis
Language J
AuthorList Ryoko Inaba1), Yukihiro Yoneda2), Masayasu Tabuchi2), and Etsuro Mori3)
Affiliation 1) Neuropsychology Section, Hyogo Brain and Heart Center at Himeji
2) Neurology Service, Hyogo Brain and Heart Center at Himeji
3) Divisions of Clinical Neurosciences, Hyogo Institute for Aging Brain and Cognitive Disorders
Publication Japanese Journal of Neuropsychology: 17 (2), 147-155, 2001
Received May 29, 2000
Accepted Dec 18, 2000
Abstract We report a 5-year neuropsychological and neuroradiological follow-up study in a patient with persistent profound amnesia following herpes simplex encephalitis (HSE).
The patient was a 40-year-old right-handed male who suffered from HSE and received acyclovir therapy 5 years ago. Brain MRIs showed extensive damages bilaterally in the medial temporal lobe and basal forebrain, which were more prominent on the right side. Formal neuropsychological examinations showed severe intellectual decline associated with marked anterograde amnesia for both verbal and non-verbal materials and retrograde amnesia extending 10 to 15 years before the onset. His profound amnesia has persisted over the follow-up 5 years. An MRI-based volumetry of the temporal lobe structures showed severe (9% of the average control volumes at 1-year post-onset and 5% at 5-year post-onset) atrophy of the medial temporal lobe including hippocampus, parahippocampal gyrus and amygdala, and moderate (42% of the average control volumes at 1- year post-onset and 31% at 5-year post-onset) atrophy of the lateral temporal lobe.
We speculated that severe atrophy of the medial temporal lobe, extending to the basal forebrain, produced severe persistent anterograde and retrograde amnesia in this patient. This study quantitatively showed that HSE predominantly affects the medial temporal lobe, producing amnesic syndrome, and that gradual progression of the atrophy occurs at the chronic stage of HSE.
Keywords Encephalitis, herpes simplex encephalitis, memory, amnesia, magnetic resonance imaging

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