John Libbey Eurotext

Revue de neuropsychologie

The submission of an oblivious patient: the point of view of an amnesic man Volume 9, issue 2, Avril-Mai-Juin 2017

Figures

  • Figure 1
  • Figure 2
Authors
1 Plein Ciel,
75, rue Bataille,
69008 Lyon,
France
2 Université Lyon 2,
Laboratoire EMC,
EA 3082,
69500 Bron,
France
3 Hospices civils de Lyon,
Hôpital neurologique,
Service neuro-cognition et neuro-ophtalmologie,
69500 Bron,
France
* Correspondance
  • Key words: amnesia, limbic encephalitis, paroxysmal anxiety, testimony
  • DOI : 10.1684/nrp.2017.0418
  • Page(s) : 99-107
  • Published in: 2017

Limbic encephalitis (LE) used to be considered extremely rare, mainly associated with cancer, and unresponsive to treatment. Recently, many studies demonstrated that LE is more frequent than previously thought and that a substantial number of patients may recover. The symptoms are both neurologic and psychiatric such as loss of memory and anxiety. We present the case of a 62-year-old man (Mr. R.) that was characterized by subacute anterograde amnesia without seizure and preceded by a prodromal phase of asthenia and paroxysmal anxiety. Mr. R. also complained of prosopagnosia and topographical amnesia. LE AK5 (a known auto-antigen of LE) was identified as the target of antibodies in the CSFs and sera. Brain IRM showed bilateral hippocampal hyperintensities. CSF analysis showed a mild pleiocytosis with elevated immunoglobulin G index and oligoclonal bands. Hippocampal atrophy was observed on control brain MR. Clinical response to immunotherapy was poor, with persistence of severe anterograde amnesia. Mr. R. looked into the new operation of his memory and wrote “the submission of an oblivious patient”, which help him to share ideas and knowledge with his neurologist, for four years. We published sample texts.