Alcoholic Dementia From Neurological Disorders Due to Alcoholism
Together with the confusion, nearly always a profound disorder of memory is observed, in which memory of recent events, those which just happened, is chiefly disturbed, whereas the remote past is remembered fairly well. This confusional state may last indefinitely or for only several weeks. However if the patient appears calm and clear of consciousness (i.e. appears in better possession of his faculties; he receives information correctly) it is noted his memory remains deeply affected. This reveals itself primarily in that the patient constantly asks the same questions and repeats the same stories. At first, during conversation with such a patient, it is difficult to note the presence of psychotic disorder; the patient gives the impression of a person in complete possession of his faculties; he reasons about everything perfectly well, draws correct deductions from given premises; makes witty remarks, plays chess or a game of cards; in a word, displays himself as a mentally sound person.
Only after a long conversation with the patients; one may note that times he utterly confuses events and that he remembers absolutely nothing of what goes on around him; he does not remember whether he had dinner, whether he was out of bed. On occasion the patient forgets what happened to him just an instant ago; the examiner comes in, converses with him steps out for a minute; and upon returning the patient has absolutely no recollection that the examiner had been with him.
In conversation they may repeat the same piece of information twenty times, remaining wholly unaware that they are repeating the same thing in absolutely stereotyped expression. It often happens that the patient is unable to remember his attending physician, nurse or visitor, so that each time he sees them, even though seeing them constantly, he swears that he sees them for the first time.
With all this, the remarkable fact is that, forgetting all events which have occurred, the patient usually remember quite accurately the past events. In some cases, recent events will be remembered but not the time when they occurred. At times they may believe themselves to be in a setting (or circumstances) in which they were some 30 years ago, and mistake persons who are around them now for people who were around them at the time but who are now perhaps dead.
In regard to the confusion: When a patient was asked how he had been spending his time, the patient would very frequently relate a story altogether different from that which actually occurred; for example, he would tell that yesterday he took a ride to town whereas in fact, he has been in bed for two months, or he would tell conversations which has never occurred, and so forth. On occasion, such patients invent some fiction and constantly repeat it so that a peculiar delirium develops, rooted in false recollections.
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