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The general physical examination was normal. She weighed 72 kg and had normal vital signs. Her neurological examination was remarkable for moderately impaired long-term memory and nystagmus on horizontal gaze in either direction. The remainder of the examination was normal. A magnetic resonance imaging scan showed two small, highsignal intensity lesions in the left centrum semiovale. Her first EEG showed intermittent left temporal theta activity and the second EEG showed left mid-temporal sharp waves
Correspondent to its cytoarchitectonic structure, the frontal lobe is traditionally divided into two parts, which are important in two major areas. The posterior part controls motor movement and is subdivided into a premotor and a motor area, which control movement preparation and actual execution of movement respectively. The anterior part of the frontal lobe, the prefrontal cortex, is especially important in higher mental function, as in anticipation and planning, initiative, judgement, and in affect control, will power, and the determination of personality (Bechara et al., 1999 Raine et al., 2000). The prefrontal cortex can be further subdivided into the dorso-lateral cortex and the orbito-frontal cortex. This subdivision of the prefrontal cortex is still simple and it should be noted that the orbito-frontal cortex itself is a heterogeneous area connected with a wide range of other prefrontal, limbic, premotor, sensory areas and subcortical nuclei (Cavada et al., 2000). For the...
She was readmitted for video-EEG monitoring. She was alert and oriented but had persistent personality changes. Her short-term and long-term memory were intact, she could spell appropriately, she could calculate and she could follow three-step commands without difficulty. Her general neurological examination
A 26-year-old right-handed man sustained a severe closed head injury 8 years before presentation. He was in a comatose state for 23 days and, on regaining consciousness, was severely impaired. He required retraining of language (speaking and writing), simple motor tasks (tying shoes, eating), and other basic skills during an 18-month inpatient rehabilitation. Residual deficits included a left hemiparesis, bilateral fourth nerve palsies, impaired reading comprehension, and difficulty in processing short-term memory.
Working memory has provided us with an archetype of a persistently active state. In the aftermath of a cue, neuronal networks remain active during a delay period (Funahashi et al., 1989). Computationally, such persistent activity can be produced through a relative balance of excitation and inhibition, although such reverberation may be sustained through asynchrony and quenched through synchronization (Gutkin et al., 2001). Further experiments of up and down states in cortex (Shu et al., 2003 Haider et al., 2006) have shown that the inhibitory and excitatory conductances maintain an impressive degree of balance despite large variations in cortical activity. In order to accomplish such persistent activity without fast inhibition, the cortex may need to organize activity in spatiotemporal wave patterns (Huang et al., 2004). How anatomically constrained waves in intact cortex relate to these slice data remains unclear (Rubino et al., 2006), although one clear difference is the higher...
In patients with foci in the left lateral temporal cortex, mild impairments have been documented in the areas of verbal perception,8 0 object naming,8 1 and language processing.82 Impairments in span of attention or working memory have also been noted in patients with temporal neocortical epilepsy.23 An association between impaired discourse ability and working memory has been found in patients with temporal lobe epilepsy.84 Mild visual perceptual deficits have been reported in association with foci in the right temporal lobe.85
Temporal epileptiform discharges (see Figure 17.2A) . Two of ten seizures witnessed during monitoring were focal in onset, and these rapidly secondarily generalized. She also had generalized myoclonic tonic events (see Figure 17. 2B) that resembled flexor spasms (with elevation and flexion of both upper and lower extremities), and generalized myoclonic-astatic events during which she would fall forward . A brain MRI study revealed left temporal lobe encephalomalacia, as well as periventricular and subcortical white-matter signal hyperintensities there was also widening of the sylvian fissure, and deepening and widening of sulci extending into the posterior portion of the left temporal lobe (see Figure 17. 3) . Neuropsychological testing revealed a functional level comparable to a 2- to 3-year-old child, and significant short-term memory deficits After reviewing the results, a complete corpus callosotomy was recommended . At the 6-month follow-up visit, her mother described five brief (
Working memory A very interesting behaviour and neuropsychological pattern of impairment can be observed in patients with frontal nonconvulsive status epilepticus. It is important to note that in contrast to a generalized tonic-clonic status, which is the repetition of the same seizure, the nature of frontal nonconvulsive status and frontal seizures is completely different. In contrast to frontal lobe seizures, seizure semiology of nonconvulsive status is dominated by negative seizure phenomena. Without EEG recording the epileptic nature of this state is easily overlooked, and patients appear rather strange, since they are slowed, dysphoric, morose and difficult. When neuropsychologically examined during the seizure we found in five cases consistently generally reduced activity, fluctuating orientation, reflexive and no self-initiated behaviour, perseverations, intrusions, apractic signs, problems to shift between tasks, impaired working memory on a higher cognitive level and...
The neodissociative model of hypnotic behaviours also provides the basis for an account of more pathological phenomena such as dissociative amnesia, fugue and multiple personality disorder (Kihlstrom, 1994 Spiegel and Cardena, 1991). According to such a view, the formation of amnesic barriers within the executive ego is a common defensive response in the face of trauma. These barriers serve an adaptive function in that they protect the individual from experiencing potentially overwhelming negative affect associated with the traumatic event. However, pathological dissociative amnesia can arise if the barrier within the executive ego endures to the point where the memory loss itself becomes distressing or debilitating. In the case of dissociative fugue, the amnesic barrier conceals large tracts of autobiographical memory as well as the traumatic events themselves. Without access to this autobiographical information, the fugue sufferer not only reports amnesia but also
A line attractor mechanism in a cell can work as an analog memory of displacements along the neutral region (Malmgren H, personal communication). At the same time, it will not posses any robustness to noise or presence of drift. Noise will generate a random walk along the line which can be arbitrarily far from a starting point (the expectation value). A drift will be integrated and memorized positions will be mixed with drifts of unknown amplitude and duration. A line attractor in its pure form will therefore only work in mathematically ideal systems and not in a living cell.
The study of memory in epilepsy has also examined remote and autobiographical memory. It has been shown that people with temporal lobe epilepsy have difficulty retrieving information based on past experiences as well as information based on recent events or new learning.36-39 Despite these deficits in the personal episodic realm (specific events), memory for personal semantic information (facts about oneself) can remain intact.37 39 These remote memory deficits have been demonstrated in both left and right temporal lobe epilepsy, although in some instances they may be related to the hemisphere of seizure onset. For example, right but not left temporal lobe foci have been associated with impairments in familiarity judgements for famous faces, but foci in either temporal lobe can result in impairments in naming such faces or in providing information about famous people.39
Frontal subfunctions speed attention, response maintenance and inhibition, motor coordination, and short-term memory. Both frontal and temporal lobe epilepsy were associated with deficits in the short-term memory and speed attention domains, whereas only patients with frontal-lobe seizures were characterized by impairments in the motor coordination and or response inhibition domains. In patients with epileptogenic foci in the frontal lobes, impairments have not been found to be related to the laterality of the focus, or to the site of localization within the frontal lobe.52-54
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