Postoperative reduplicative paramnesia in a patient with a right frontotemporal lesion

Abstract

Reduplicative paramnesia (RP) is a well recognized neurological phenomenon, characterized by a false belief that a familiar person or place has been duplicated. In the development of RP, right-dominant frontal lesions are commonly observed. We report a 73-year-old woman who developed reduplication of people and places 3 months after the surgical removal of a large right frontotemporal meningioma. About 1 year after the surgery, her RP diminished after a small dose of risperidone. Neuropsychological evaluation was performed before surgery, after surgery when RP was present and again after recovery of RP. In accordance with the literature, the present case study suggests that a right hemispheric lesion is the essential neuroanatomical substrate in the development of RP. However, no single neuropsychological factor can fully explain the development and resolution of RP. Multiple factors, including neuroanatomical, cognitive and environmental factors seem to be dynamically involved.

Modulation of environmental reduplicative paramnesia by perceptual experience

“…The fact that our patient was able to identify public buildings and to locate them argues against an explanation of ERP in terms of topographical disorientation (Fisher, 1982), or visuospatial failures (Benson et al, 1976;Benson & Stuss, 1990;Budson et al, 2000;Kapur et al, 1988;Patterson & Mack, 1985;Ruff & Volpe, 1981). In contrast, similarly to previous reports, our patient had a severe memory impairment (Benson & Stuss, 1990;Budson et al, 2000;Hakim et al, 1988;Kapur et al, 1988;Patterson & Mack, 1985;Pisani et al, 2000;Ruff & Volpe, 1981;Yamada et al, 2003). However, the memory deficit alone does not provide a satisfactory explanation of his ERP, since his score in a memory test was actually worse before ERP became manifest.…”

“…However, the memory deficit alone does not provide a satisfactory explanation of his ERP, since his score in a memory test was actually worse before ERP became manifest. A third cognitive deficit that has been discussed by several authors is executive dysfunction (Benson & Stuss, 1990;Budson et al, 2000;Kapur et al, 1988;Moser et al, 1998;Patterson & Mack, 1985;Yamada et al, 2003).…”

“…Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions 2005) or transient encephalopathy with negative brain imaging and post-mortem examination (Hudson, Rollins, Anderson, Johnston-Brooks, & Filley, 2008) have been described. ERP is often accompanied by other cognitive deficits affecting memory, executive, attentional, visuospatial, and topographical functions (Benson et al, 1976;Benson & Stuss, 1990;Budson et al, 2000;Hakim, Verma, & Greiffenstein, 1988;Hudson et al, 2008;Kapur et al, 1988;Moser et al, 1998;Pisani et al, 2000;Ruff & Volpe, 1981;Yamada et al, 2003). Therefore, several mechanisms have been proposed: a special form of topographical disorientation (Fisher, 1982), severe memory deficit (Staton et al, 1982), or combinations of cognitive impairments, e.g., an abnormal sense of familiarity with an unknown environment combined with altered memory (Pisani et al, 2000) (Hakim et al, 1988;Moser et al, 1998), mixed executive and visuospatial disorders (Benson et al, 1976), an impairment of memory associated with executive failures (Yamada et al, 2003), or the combination of a dysexecutive syndrome with memory and visuospatial deficits (Budson et al, 2000;Benson & Stuss, 1990;Kapur et al, 1988;Patterson & Mack, 1985;Ruff & Volpe, 1981).…”

Reduplicative Paramnesia After a Right Frontal Lesion

“…9,[11][12][13]17,18,[20][21][22] Two typical cases of RP after a right frontal lesion have been reported. 9,[11][12][13]17,18,[20][21][22] Two typical cases of RP after a right frontal lesion have been reported.…”