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A blank slate – apropos a clinical case

Published online by Cambridge University Press:  13 August 2021

S. Freitas Ramos
Affiliation:
Department Of Psychiatry And Mental Health, Local Health Unit of Guarda, Guarda, Portugal
M. Seabra
Affiliation:
Neurology, Faculty of Medicine of the University of Porto, Porto, Portugal
P.Â. Horta*
Affiliation:
Psychiatry, CHVNG/E, Vila Nova de Gaia, Portugal
J. Guimarães
Affiliation:
Neurology, Faculty of Medicine of the University of Porto, Porto, Portugal
R. Grangeia
Affiliation:
Psychiatry, Faculty of Medicine of the University of Porto, Porto, Portugal
*
*Corresponding author.

Abstract

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Introduction

Dissociative Amnesia remains an enigmatic and controversial entity. It is classically described as responsible for autobiographic amnesia associated with a traumatic event.

Objectives

To report a clinical case and review the literature.

Methods

We collected data from the patient’s clinical file with his informed consent. We conducted a non-systematic review of the literature.

Results

A 46-years-old patient presents to the emergency department for sudden global retrograde amnesia, with multiple domain amnestic syndrome (impairing verbal and visual memory, processing speed, mental flexibility, calculus, executive functions and language). He was initially admitted for a suspected infectious meningoencephalitis, which was not confirmed. Later an autoimmune encephalitis was pursued. Brain MRI showed a nonspecific left temporal and hipocampal hyperintensity and the EEG a mild left temporal dysfunction. The autoimmune encephalitis panel was negative and the formal diagnostic criteria were not met. The neurologic examination at discharge presented only with autobiographical and semantic amnesia. On the mental state examination, he presented with depressive symptoms reactive to the situation. There was no evident traumatic event apart from a promotion received the day before the amnesia started. He was prescribed escitalopram 10 mg/day. The amnesia was maintained at 9 months follow-up.

Conclusions

Our case report illustrates a case of amnesia without evident organic or psychogenic cause, assumed as a dissociative amnesia. Further studies are necessary to clarify the pathophysiology of this condition and develop specific treatments.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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