Case history
Patient E. P. is a right-handed male who was born in 1922 and grew up in
a central California agricultural community. He has 12 years of education.
From 1941 to 1950, he traveled at sea as a radio operator for an oil
company. Afterward, he lived in Los Angeles County, working for 28 years
as a technician in the aerospace industry, then for 5 years as a part-time
consultant. In 1993 he moved to San Diego County. E. P. has been married
since 1950, and he currently lives at home with his wife. He has two grown
children.
In November of 1992, at the age of 70, E. P. was diagnosed with herpes
simplex encephalitis. His illness began with flu-like symptoms (fever and
lethargy) and an episode of memory loss (he could not remember the
names of some family members), which appeared to recover for a few days.
However, his memory then worsened, and he was admitted to the hospital,
where he received a 10 d course of intravenous Acyclovir. In the months
immediately after, E. P. experienced severe loss of appetite and a 20–30 lb
weight loss. By June, 1993 his clinical condition had stabilized; however,
profound memory impairment has persisted to the present time.
Upon first meeting E. P., one is impressed by his healthy, well groomed
appearance and his pleasant demeanor. E. P. stands 6 feet, 2 1/2 inches tall
and weighs 192 lbs. He walks with a slight limp caused by arthritis in his left
knee. He is always agreeable and cooperative during testing sessions, and
he particularly enjoys participating in computer-aided tests. During testing
sessions, he will repeatedly marvel at the invention of the portable computer,
often commenting that he “was born too early”. His conversation is
limited to events from his early life, e.g., his childhood on a farm, his
teenage hobby as a ham radio operator, and his travels during World War
II. Within a 1 hr testing session, E. P. may recount the same story almost
verbatim as many as 10 times.
Like patient H. M. (Corkin et al., 1997), E. P. is socially interactive but
lacks initiative. On a typical day, E. P. has a light breakfast when he wakes
up, and then he returns to bed where he listens to the radio. His wife
reports that when he arises a second time, he will often return to the
kitchen and have breakfast again, and sometimes he again returns to bed.
He has had breakfast as many as three times in one morning before staying
up for the day. E. P. chooses his own clothes and dresses himself. He needs
no assistance in bathing or shaving, although he often needs reminders
about these activities from his wife. In the morning, he alternates between
taking short walks around his neighborhood and sitting in his backyard or
in the living room. After lunch, he watches television or reads the newspaper
or a magazine. Often, he will suggest that he and his wife go out, but
once they leave the house (to go shopping, for example), he will become
confused and ask to return home. He watches television after dinner, and
retires early (7:00 P.M. or 8:00 P.M.).
(Stefanacci, L., Buffalo, E. A., Schmolck, H., and Squire, L. R. 2000. Profound amnesia after damage to the medial temporal lobe: A neuroanatomical and neuropsychological profile of patient E. P. J Neurosci. 20(18), p.7024.)
