College of Psychology: Faculty Proceedings, Presentations, Speeches and Lectures

Title

Amnestic Disorder in Anoxic Encephalopathy due to Cardiac Arrest

Event Location / Date(s)

Scottsdale, AZ / November 14-18, 2007

Document Type

Conference Proceeding

Presentation Date

11-14-2007

Conference Name / Publication Title

27th Annual Meeting of the National Academy of Neuropsychology

Description

Abstract

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.

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