Types of amnesia
There are two forms of the disease - retrograde (the patient does not remember events that occurred before the disease) and anterograde (the patient does not remember events that occurred after the onset of the disease).
Retrograde amnesia
As a rule, it does not affect events that happened long ago in the past, i.e. the most common cases of memory loss are about the last hours or weeks, less often - months. A sign of recovery is usually a decrease in the period of lost memory, but memory of the time immediately preceding the onset of the disease returns extremely rarely.
Anterograde amnesia
It is characterized by an unlimited period of lost memory, the duration of which is closely related to the duration of post-traumatic disorder of conscious activity. If anterograde memory loss develops as a consequence of traumatic brain injury, then the period of lost memory will depend on its severity.
There are other forms of amnesia, usually classified by developmental reasons, for example, a defensive form of the disease, displacing traumatic events from memory, or post-hypnotic - loss of the ability to reproduce events experienced in a state of hypnotic trance.
Researchers also identify spontaneous memory loss (the causes of which are probably simply not identified) and Korsakoff's syndrome (the inability to record current events), which is formed due to a lack of vitamin B1.
Regardless of the form of the disease, upon recovery, the ability to learn new skills and new information is the last to return, memory returns strictly chronologically (starting with the most distant memories), and the events immediately preceding the onset of the disease often are not restored.
Causes
Among the most common causes of amnesia are primarily traumatic brain injuries, emotional shock, tumors and strokes. However, the disease can also be triggered by a number of other diseases, for example, epilepsy, mental illness, degenerative brain diseases, metabolic encephalopathy, intoxication and herpetic encephalitis.
One example of psychogenic amnesia, for example, is dissociative fugue, which develops as a result of moving to a new place of residence or a complete change of environment. The patient may be completely unable to remember his past for months or even years, and he may suddenly remember and then forget certain events.
The reason for the development of another type of disease - dissociated - is a temporary loss of memory about traumatic events (loss of loved ones, severe stress, shock), but the memory of other events and skills remains in perfect order. It is interesting that with dissociated amnesia, the memory function is impaired only in the waking state, while in an altered state of consciousness (sleep, trance, hypnosis), the patient can restore all events.
Among the causes contributing to the development of Korsakoff's syndrome, alcoholism and unhealthy diet dominate. From the point of view of the anatomy of the brain, any dysfunction of its key parts can, depending on the severity of the injury, provoke the development of amnesia.
General description of the syndrome
Despite the huge number of different studies and publications, the process of memorizing and reproducing information is one of the most poorly studied, by the way, which is why the treatment of mnestic syndrome sometimes comes down to supportive and symptomatic therapy.
There are several memory processes:
- Memorization or fixation. This is the ability to form new neural connections, which ensure retention of a certain image in memory. The duration of memory retention is influenced by several factors: the degree of interest, content, well-being and emotional state at the time of receiving information.
- Retention (preservation). This is a kind of “processing” of information, during which everything unnecessary (from the point of view of a particular person) is “discarded” and only its essence remains.
- Playback. This is the process of “retrieving” images from memory. It can be involuntary, for example, some music or smell is associated with a certain event, and voluntary, when a person remembers what is necessary at that particular moment.
- Recognition is the subconscious comparison of a new image with something previously seen or heard.
- Forgetting. This is a completely physiological state when events that are uninteresting for an individual are gradually “erased”.
In patients with fixation amnesia, it is the process of memorizing new information that is impaired, but retention, reproduction and recognition are partially preserved. They do not lose previously acquired professional skills, subconscious reactions, behavior and communication with other people are preserved.
Symptoms
Often, amnesia is accompanied by other disorders of the nervous system and cognitive function of the brain, for example, pronounced thought disorders, slurred speech, inability to control attention, anxiety or depression.
Anterograde amnesia
Patients with anterograde amnesia exhibit completely normal behavior upon first meeting, but memory problems are easily identified if recent events are mentioned in conversation.
Retrograde amnesia
People suffering from retrograde amnesia have excellent memory of recent events, but have difficulty remembering events that happened a week or month ago. This form of the disease may not affect events of the distant past, so it is necessary to analyze their memories step by step. The main difficulty in identifying retrograde amnesia is the tendency in many patients to fill in memory gaps with false memories.
Korsakoff's syndrome
The presence of symptoms of Korsakoff's syndrome is indicated by the patient's disorientation in time and space, impaired attention and false memory (the patient reports fictitious events). The most resistant to forgetting information is the memory of self-identification (first name, last name, date and place of birth).
Amnesia, in which the patient does not remember distant events of his past and personal identifying data, is most likely of a psychogenic nature, i.e. caused by serious mental disorders.
Qualitative memory impairments
Paramnesia
Paramnesia (distortions, deceptions), or qualitative memory impairments, occurs both independently and in combination with quantitative impairments. The complexity of the symptoms of paramnesia makes it difficult to distinguish and classify them.
Memory disorders also include the phenomena of previously seen, heard, experienced, tested, told (deja vu, deja entendu, deja vecu, deja eprouve, deja raconte) - the first time seen, heard, read or experienced is perceived as familiar, encountered before and in present moment recurring; and, conversely, phenomena of never seen, never heard, never experienced, etc. (jamais vu, jamais vecu, jamais entendu, etc.). The familiar, known, habitual is perceived as new, never seen before. A past life is remembered without the feeling of a personal experience.
Illusions of recognition
Among memory disorders, illusions of recognition . With such deviations in the functioning of memory, unfamiliar faces, objects, and surroundings are mistaken for others that actually exist and are known to the patient. Most often they occur in relation to people. Illusions of recognition usually concern one or a limited circle of persons or objects, less often they are multiple - they are unstable and are immediately forgotten. They arise against the background of disorientation in place, time and situation with confusion, amnestic syndrome (intoxication), vascular, senile psychoses. Illusory false recognitions with a feeling of distant similarity without complete identification of objects can occur during asthenic conditions. In psychological terms, the appearance of illusions of recognition is probably associated with a violation of the mechanisms of apperception - the comparison of current impressions with past experience, which forms the basis for recognizing objects.
Reduplicated Pick paramnesia
Reduplicated Peake's paramnesia is manifested by confidence in the existence of doubles in objects perceived at the moment. The perception itself does not suffer, only the unification of the image of perception with the corresponding memory is disrupted, as a result of which both images are experienced separately. Unlike the “already seen” phenomenon, here there is an experience of doubling, and not a feeling of repetition of the situation. Observed in relatively mild vascular, atrophic and other organic processes that occur in the second half of life, described in alcoholic delirium.
Echomnesia
Echomnesia , the repeated reproduction of the same memory, should also be distinguished from reduplicated paramnesia At this time, the patient several times in a row feels himself in the same situation, which corresponds to a recurring memory, and for several minutes he seems to disconnect from the current impressions.
There are also pseudo-reminiscence (false memories).
Confabulation
Confabulations are pathological fictions that patients mistake for memories of real events of the past.
According to one approach, a distinction is made between mnestic and fantastic confabulations. The former are observed with amnesia, the latter with paraphrenia and confusion. Mnestic confabulations, in turn, are divided into ecmnestic (projected into the past) and mnemonic (relating to the current situation, to the present time).
E.Ya. Sternberg distinguishes between vicarious, ecmnestic, fantastic, delusional and hallucinatory confabulations. Replacement confabulations arise against the background of severe amnestic memory loss. They are observed in Korsakoff psychosis, senile and vascular psychoses, and in organic diseases of the central nervous system. The content of ecmnestic confabulations are events of the early years of life. There is a “shift of the situation into the past,” when memories of distant events obscure current impressions. Fantastic confabulations are fictions about extraordinary events.
Hallucinatory (pseudohallucinatory) confabulations are states of visual and auditory pseudohallucinations, the content of which are various events that allegedly took place in the past. Occurs in schizophrenia.
Influxes of confabulations can be expressed by states of confabulatory confusion and confabulation. Confabulatory confusion is manifested by the filling of consciousness with abundant confabulations of everyday content, accompanied by false recognition of the environment and persons, incoherent thinking, fussiness and confusion.
Confabulosis is a psychopathological syndrome manifested by an influx of fantastic confabulations, not accompanied by confusion, amnestic disorders and disorientation.
The statements of patients are reminiscent of delusional ideas of grandeur, and therefore this syndrome is also called expansive confabulosis.
Cryptomnesia
Cryptomnesia is manifested by a violation of the ability to identify the source of memories, which leads to a weakening of the difference (up to its complete disappearance) between actually occurring and personally experienced events and events seen in a dream, or which became known from books, films, and stories of others.
Cryptomnesia includes associated memories, in which what is read, heard or seen in a dream is regarded as having actually happened to the patient himself.
Tags: neuropsychology
Diagnostics
To treat amnesia, it is necessary to determine as accurately as possible the cause of the disease and all possible parallel provocations. To do this, when symptoms are identified, a comprehensive examination is necessary with mandatory consultation with a psychiatrist, narcologist and neurologist.
For in-depth diagnostics, special detailed testing of memory functions and examination by a traumatologist, infectious disease specialist, neurosurgeon and other highly specialized specialists are used. If necessary, a blood test, ECG, MRI, computed tomography and toxicological analysis are prescribed.
Types of alcoholic amnesia
Toxic ethanol metabolites block the transmission of nerve impulses to the central nervous system. Thus, there is a loss (irretrievable) of individual fragments from memory when drinking alcohol.
Alcohol amnesia is divided into two types. Palimpsest refers to a retrograde form of lacunar amnesia. But at the same time it is considered a predecessor of the amnestic form of alcoholic intoxication.
Types of alcoholic amnesia:
- Partial (lacunary) - the sequence of events is preserved, but individual fragments fall out of memory. This type is divided into forms: Congrade - events that occurred during the acute period of the disease fall out of memory;
- Retrograde – all events preceding alcohol intoxication disappear from memory. But at the same time, information from past years is stored in long-term memory, and the patient can reproduce it;
- Anterograde (combined) – there is a violation in the “coding” of information during a “toxic attack”. A person cannot reproduce the events that happened during the day (where he was, what he said).
Ethanol and its metabolites are highly neurotoxic. Ethanol has an inhibitory effect on GABA receptors, but is an antagonist for glutamate receptors. Chronic alcoholism causes dysfunction of these neurotransmitter systems. As a result, intercellular metabolism fails. The resulting cytotoxic proteins damage nerve cells.
Damage to the nervous system due to alcoholism. Neurology, neuropsychiatry, psychosomatics / O. E. Zinovieva, N. V. Vashchenko, O. E. Mozgovaya, T. A. Yanakaeva, A. Yu. Emelyanova - 11 (add. 2). - 2019. - 83 - 87 With.
Treatment
The structure and function of human memory have not yet been fully studied, and research in this area is being actively conducted throughout the world. Modern data show that in humans, as in some animals, not only the brain, but the entire nervous system is involved in the process of memorization.
Treatment of memory loss must be carried out carefully and step by step, especially to prevent the replacement of real memories with false ones. Treatment for amnesia begins with neutralizing the underlying illness or traumatic event, as well as the factors that contributed to memory loss.
A wide range of antioxidants and neuroprotectors are actively used for drug therapy, for example, cerebrolysin, memantine, cortexin, cytoflavin, Semax, citicoline, ginkgo biloba extract, glycine and vitamins. A variety of techniques and techniques of neuropsychological rehabilitation are very effective in promoting recovery.
Amnesia, the treatment of which is complicated by the psychogenic nature of the disease or for the treatment of non-progressive forms, neuropsychological therapy is effective. If the effect of the underlying disease and other provocateurs of amnesia is eliminated, drug therapy is aimed at enhancing cholinergic transmission in the brain. For this purpose, drugs such as piracetam, gliatilin, pyritinol or encephabol, Cerebrolysin and Semax are prescribed.
General information
Memory is the highest mental function that allows you to accumulate experience, store information and, if necessary, reproduce it again. The mental process improves with age, reaching optimal development around 20–25 years. Physiological regression is observed after 45–50 years.
When alcohol is abused, its breakdown products selectively accumulate in the central nervous system. Ethanol is highly lipophilic, so it easily penetrates the protective barrier of the brain. During the breakdown of ethanol, a toxic effect occurs on nerve cells, which partially die.
The death of neurons as a result of physiological aging of the body is considered normal. Memory weakens with age - current events or new information are not remembered in full. But under the influence of systematic ethanol poisoning, a large number of neurons die, regardless of age. How many cells are damaged as a result of intoxication depends on the systematic dosage of ethanol.
Alcoholic palimpsest (or perforation amnesia) was first described by K. Bonhoeffer in 1901. He classified this type of amnesia as a mental disorder resulting from the effects of ethanol on the central nervous system. A specific disorder is characterized by the loss of the ability to reproduce the course of events or episodes that occurred during the period of alcohol intoxication. The person does not remember the events that occurred at the time of intoxication. That is, only the general plot is stored in memory.
Narcologists believe that such memory lapses are the first signal of mnestic disorders. Perforation amnesia is considered the beginning of the formation of addiction (stage I).
Perforation amnesia is considered a type of fixation amnesia. Only individual blocks of information are not recorded in memory. With palimpsests, the ability to capture an event and reproduce individual details or episodes that occurred during the period of alcohol intoxication is lost.
Smirnova S.V. Fundamentals of pathopsychology: a textbook for students majoring in “030301-Psychology.” /S.V. Smirnova. – Blagoveshchensk: AmSU Publishing House, 2010. – 32 – 38 p.
Alcohol-induced memory loss becomes more frequent with systematic alcoholism. Palimpsest is the first sign of the development of alcoholism.
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Consequences
Alcoholic palimpsest appears against the background of systematic intoxication. If a person continues to abuse alcohol, then over time the pathological symptom develops into a disease - amnesia against the background of a formed psychophysical dependence.
Chronic alcoholism leads to toxic damage to all organs and systems (ascites, cirrhosis, peptic ulcer). But the central nervous system suffers first. Systematic poisoning leads to irreversible degenerative processes in brain tissue. Against the background of prolonged abuse, Korsakoff psychosis, dementia or alcoholic encephalopathy develops. Without timely therapeutic correction, the prognosis is unfavorable - disability, death.
