Abstract
This study followed a 52-year-old male patient, who had suffered from severe impairment in recent memory due to se- quelae of herpes encephalitis, for 20 years. He returned to his highly intellectual work and performed well despite his doctor’s prediction. While the patient showed consistently poor results on various neuropsychological memory tests, he demonstrated incredible performance at work. This case exemplifies an extreme case that declarative memory is formed with the support of semantic memory, procedural memory, and his strong interests. Additionally, it offers lessons that results on memory tests do not necessarily correspond to the actual level of competence. The focal sites were found on both sides of the medial temporal lobe, predominantly on the left side. The T2-weighted magnetic resonance images (MRI) obtained 9 years after the onset confirmed widespread damage to the left brain including parahippocampal gyrus, hippocampus, spindle gyrus, and amygdaloid complex, with microlesions extending from the right parahippocampal gyrus to its antero-interior rim. However, the damage to hippocampus was presumed to be minor.
Highlights
Memory consists of declarative memory, procedural memory, and priming memory [1,2]
Previous studies have revealed that injuries to the hippocampus and related structures lead to impairments in recent memory of declarative memory while procedural memory and priming memory are preserved [3,4,5,6,7]
The patient performed well on visual memory, but poor on the auditory version. This is a significant case that validates several essential hypotheses which has been long proposed regarding memory. This didactic case demonstrates that results on memory tests do not necessary correspond to actual capabilities
Summary
Memory consists of declarative memory (episodic memory and semantic memory), procedural memory, and priming memory [1,2]. The patient we are reporting in this study had succeeded in resuming his highly intellectual work at an excellent level while he had been consistently demonstrating poor results on neuropsychological tests of memory that we had administered for over 14 years since the onset. His boss reported that when his boss asked the patient’s colleague about whether he was competent, his colleague replied that he might have been a little less competent than before, but his retained capacity was good enough as his ability was very outstanding to begin with According to his wife, memory impairment often occurred during the first three years after the onset. Memory impairment often occurred during the first three years after the onset He did not remember about a package which he received and placed at the entrance by himself, and asked his wife what the strange object was five minutes later. He reached the level of 2nd Dan (grade) given to advanced players
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