It is striking that all the cases investigated showed short-term memory dysfunction. One patient who had recovered from paroxysmal symptoms (hypersomnia attacks and bulimia) 6 years earlier showed progress in the short-term memory dysfunction. A pathologic condition in the temporal lobes may be suspected in Kleine-Levin syndrome.

A case of Kleine-Levin syndrome with typical periodic hypersomnia and bulimia was diagnosed. On examination with single photo emission tomography (SPECT) (CERETEC) during a relapse period and 2 weeks later there was marked cortical hypoperfusion of the frontal and temporal lobes, especially on the left side as well as in the right parietal lobe. Neuropsychological testing performed 1 week after a relapse showed a reduction in encoding to memory function of verbal learning indicating neocortical damage of the left fronto-temporal region. A follow-up 2 months later after the patient had spontaneously recovered showed only a slight left fronto-temporal disturbance. CT and MRI of the brain were normal although the MRI showed a large and asymmetric mamillary body. Neuropsychological testing 6 years after recovery showed pronounced reduction in short-time verbal and visual memory. Seven years after recovery SPECT demonstrated a normalized frontal perfusion but still a slight hypoperfusion in the left temporal lobe. Our results correlate to autopsy findings in two cases described previously.

The authors used neuropsychological tests to assess and classify adult patients with attention deficit hyperactivity disorder (ADHD) and controls. Four memory tests correctly classified 81% of subjects. The memory tests were: the auditory Consonant trigram test, the Benton Visual Retention test, the Rey Auditory Verbal Learning test, and the modified Diagnosticum für Cerebralschädigung. The patients scored lower than controls also in other tests sensitive to frontal lobe dysfunction. The results underpin the importance of neuropsychological testing in adult ADD, but also support notions of a working-memory deficit linked to a dysfunction in the prefrontal cortex in these patients.

No abstract

The results indicate that the dichotic test is measuring one of the important ADHD deficits.