Amnestic Disorder in Anoxic Encephalopathy due to Cardiac Arrest
Event Location / Date(s)
Scottsdale, AZ / November 14-18, 2007
Conference Name / Publication Title
27th Annual Meeting of the National Academy of Neuropsychology
Objective: Varied neurocognitive presentations have been ascribed to anoxic encephalopathy caused by cardiac arrest (CA), most notably amnesia and more generalized cognitive deficiencies. This case study reports neuropsychological findings in a patient with anoxic encephalopathy due to CA.
Method: The 47-year-old, college educated patient suffered CA two months before examination. He was defibrillated twice, anoxic for 10–12 min, and had LOC for 3 days. ECG was significant for cardiomyopathy. MRI, CT, and EEG were negative. Neuropsychological evaluation assessed effort, intellectual, memory, executive, language, motor, attention, and personality functioning.
Results: Examination showed amnestic disorder with profound memory impairment (WMS-III General Memory Index = 45, RAVLT Delayed Recall Raw Score = 0, and ROCFT 5-Minute Delay T < 20). Intellectual functioning (WAIS-III FSIQ = 79) and attention/concentration (Working Memory Index = 99) were relatively intact. Impairments other than amnestic disorder were noted in executive functioning (WCST Perseverations T = 31), verbal fluency (FAS T = 32) and motor dexterity (Grooved Pegboard T = 29). Although the patient was not seeking disability compensation, four effort tests were administered. Three accurately classified him as a non-malingerer and one inaccurately classified him as malingering. Several embedded effort measures accurately classified the patient as nonmalingering (WCST, FTT, MMPI-2 FBS), but some WMS-III measures incorrectly classified him “probable malingerer.”
Conclusions: CA causes amnestic disorder with additional specific neurocognitive deficits. The typical pattern of post-CA cognitive impairment can be established during post-acute recovery. Some widely applied effort tests and embedded measures are inaccurate in amnestic disorder caused by anoxia.
Puentes, G. A.
(2007). Amnestic Disorder in Anoxic Encephalopathy due to Cardiac Arrest. 27th Annual Meeting of the National Academy of Neuropsychology.
Available at: https://nsuworks.nova.edu/cps_facpresentations/1581