Long-Term Retrograde Global Amnesia Following Minor Trauma

Abstract

Patient: Male, 41-year-old Final Diagnosis: Dissociative amnesia • dissociative disorder • post-traumatic stress disorder (PTSD) Symptoms: Psychotic symptoms • PTSD-symptoms • retrograde amnesia Medication: — Clinical Procedure: Cognitive remediation • psychoeducation Specialty: Psychiatry Objective: Unusual clinical course Background: Retrograde amnesia has several causes and may be the core concern in several conditions. When acute, somatic, and neurologic causes are excluded, along with substance use, a consideration of psychiatric disease is imminent. Here, we present a case with amnesia, where diagnostics and treatment were challenging due to severe psychiatric symptoms and course of the disease. Case Report: After a minor trauma while driving an electric scooter, a 41-year-old man lost all memories of the past 20 years. The patient was raised in a refugee camp, where he experienced traumatic events, and later came to Denmark and established family and work life. He had 1 prior contact with the psychiatric ward. After the incident, the patient was brought to the emergency room. The patient could not recognize his wife or children and believed he was 21 years old and living with his mother in the refugee camp. A full somatic and neurological workup was performed and no somatic or organic cause could explain the retrograde amnesia. He developed post-traumatic stress disorder (PTSD) and psychotic symptoms. Treatment consisted of a combination of psychoeducation, cognitive remediation, and medical treatment for psychotic symptoms and PTSD. Conclusions: The diagnosis “prolonged delirium”, “PTSD”, and “dissociative amnesia” were considered. Psychiatric comorbidity and previous traumatic experiences might have contributed to the development of long-term amnesia, which eventually was considered to be dissociative. During 8 months, the patient slowly regained his memory. It is impossible to conclude with certainty whether the successful outcome was the result of psychological treatment, pharmacological treatment, the passing of time, or a mixture of these.

Long-lasting dissociative amnesia

“…Her observeredes langsom remission over 8 mdr. [5]. Sandsynligheden for remission hos patienten i denne sygehistorie er uvis.…”

“…Sandsynligheden for remission hos patienten i denne sygehistorie er uvis. Der findes ingen evidensbaseret behandling for DA [5]. Det er usikkert, om patienten ville have profiteret af laengerevarende psykoterapi.…”