Benson D F, Djenderedjian A, Miller B L, Pachana N A, Chang L, Itti L, Mena I
Department of Neurology, UCLA School of Medicine, USA.
Neurology. 1996 May;46(5):1239-43. doi: 10.1212/wnl.46.5.1239.
We present a case of acute alcohol-induced Korsakoff amnesia. A severe amnestic-confabulatory syndrome characterized the early clinical status. The initial neuropsychological tests demonstrated severe learning deficits plus impaired performance on many, but not all, tests of frontal lobe function. Single-photon emission CT (SPECT) at this stage showed hypoperfusion in the orbital and medical frontal regions and the medial diencephalic area. Four months later, the patient's amnesia remained but there was no confabulation. Repeat neuropsychological tests confirmed an ongoing severe amnesia, but performance on the frontal lobe tests now was normal. Repeat SPECT showed a return to normal perfusion in the frontal brain areas but little improvement in the medial diencephalic region. These findings along with data from the clinical literature suggest that confabulation results from dysfunction of orbital and a medial frontal cortex.
我们报告一例急性酒精所致柯萨科夫遗忘症。早期临床症状以严重的遗忘 - 虚构综合征为特征。最初的神经心理学测试显示存在严重的学习缺陷，并且在许多（但并非全部）额叶功能测试中表现受损。此时的单光子发射计算机断层扫描（SPECT）显示眶额叶和内侧额叶区域以及间脑内侧区域灌注不足。四个月后，患者的遗忘症仍然存在，但不再有虚构现象。重复的神经心理学测试证实仍存在严重的遗忘症，但此时额叶测试的表现正常。重复SPECT显示额叶脑区灌注恢复正常，但间脑内侧区域几乎没有改善。这些发现以及临床文献中的数据表明，虚构是由眶额叶和内侧额叶皮质功能障碍所致。
