IS MEMORY LOSS WITHOUT ANATOMICAL DAMAGE TANTAMOUNT TO A PSYCHOGENIC DEFICIT - THE CASE OF PURE RETROGRADE-AMNESIA

Following a car accident, a patient remained unconscious for approxima tely 20 min and confused for a few hours. When he could be questioned, he was found to have lost all past memories. The retrograde amnesia c overed his whole life and concerned autobiographic events as well as f amous facts and encyclopaedic knowledge. It also partially involved th e verbal and visual lexicon. Reading, writing and counting were no lon ger possible. The profound impairment of retrograde memory contrasted with the preservation of anterograde memory, which permitted the patie nt to reacquire some of the notions he had lost, without, however, rec overing the feeling of a personal experience of autobiographical infor mation. Four years later, the retrograde deficit was unmodified, excep t for what had been relearnt. The search for data in support of an org anic or psychological aetiology was negative. No signs of brain damage were apparent at the neurological examination and on CT, MRI and SPEC T. On the other hand, there was no evidence of a psychiatric history, psychological stress or emotional precipitants that could substantiate the hypothesis that the patient derived a primary or secondary gain f rom amnesia. We propose that cases of focal retrograde amnesia, simila r to the present one, deserve to be classified separately from organic and psychogenic forms under the label of 'functional' retrograde amne sia, a syndrome in which the threshold of activation of premorbid memo ries is abnormally raised by the trauma, leaving the encoding and retr ieval of new memories unaffected. (C) 1997 Elsevier Science Ltd.