Memory Disorders

One morning in June 2002, a young man named Steven arrived at my office for an evaluation, having been referred by his primary care physician. Steven was pleasant and amiable, and he easily made conversation. Although he had difficulty providing detail about his history, he was able to tell me that he had been having memory problems since being injured in a motor vehicle accident six months earlier. He spoke somewhat vaguely about his current circumstances: where he was living, family members in the area, and so on. Although he could recall very little about the specifics of his work, he was able to provide a step-by-step depiction of the process for handcrafting a leather vest, which had been his profession until the time of the injury.

I began the examination, administering a series of subtests from the Wechsler Intelligence Scale to gauge Steven's overall intellectual ability. He performed extremely well, and I estimated his IQ to lie in the superior range. After about an hour of testing, Steven needed to use the men's room. I showed him the way, pointing to a lavatory that was twenty steps down the hall from my office.

I was waiting in the hall halfway between the restroom and my office when he emerged less than two minutes later. He looked both ways and began walking uncertainly in my direction. He made direct eye contact with me as he passed by and nodded, ,117

flashing a warm smile. I caught up with him a moment later and asked if we had ever met. Steven shuffled his feet and looked away, remarking that he did not think so.

Steven was amnesic. He had sustained an anoxic injury (disruption of oxygen flow to the brain) during the motor vehicle accident. Despite spending well over an hour in face-to-face interaction with me, a brief interruption was sufficient to erase any memory of me or what he had been doing two minutes earlier. He later explained that he had developed a habit of pleasantly acknowledging people he encountered on the assumption that he may have met them before, although he was utterly incapable of recalling the specifics.

When we speak of memory disorders, we mean neuropsycho-logical disorders in which the cardinal symptom is memory dysfunction. These conditions are distinct from the wide range of illnesses discussed in Chapter 5, such as depression or heart disease, that can secondarily cause memory loss as one of many symptoms. Primary memory disorders include amnesia, mild cognitive impairment, and dementia; this chapter will provide an overview of them.

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