Reduplicative paramnesia: a disconnection syndrome of memory.

A case of post-traumatic reduplicative paramnesia (Capgras syndrome) is presented in which the patient experiences duplications in all three spheres of orientation (time, place, person). We postulate that these duplications are the result of a disconnection of new memory registration from past memory stores. The patient is unable to integrate present cues with premorbid experience, and bases judgments of his present orientation upon recollections from the past. A deep lesion at the right posterior hippocampus and temporo-parieto-occipital junction is suggested as the site of this postulated primary memory disconnection, based upon neuropsychological testing and CAT scan results. This right temporal atrophy and memory disconnection appears to have induced immature personality changes.