In this chapter, the patient’s first round of symptoms are described as an organic amnesia (he couldn’t remember the murder he committed) induced by the patient’s use of the drug PCP (Phencyclidine)—a sedative, hallucinogenic, and anesthetic (Sacks, 1985; Brust, 1993). The areas of the brain that could play a role in supporting these symptoms include the areas of the prefrontal cortex and the limbic system (e.g., amygdala) associated with the temporal lobe, and hence, memory. Sacks (1985) discussed attempts to treat the patient via hypnosis and sodium amytal but these served to no avail. In terms of treatment, the best possible approach for the patient at the time was to send him to a psychiatric hospital (Sacks, 1985). The patient could, therefore, attempt to contain his potentially unpredictable behavior in conditions isolated from society (Sacks, 1985). The patient’s memory loss from PCP use was common, but what was not common was the sudden retrieval of his lost memories of the murder he committed, after he sustained severe injuries from an accident (Sacks, 1985).

Injuries that included bilateral frontal lobe contusions, large subdurmal hematomas, hemiplegia (paralysis on one half of the body), and lay in a coma after the patient avoided a head-on collision with a vehicle while cycling (Sacks, 1985). According to Sacks, the patient recovered from the seizures and deep epilepsy in the temporal lobes (and other brain damage) via the following: luck, natural healing, youth, time, anticonvulsants and regular psychotherapy (Sacks, 1985). What makes this case study unique is, unlike other patients with frontal lobe damage, an expected nonchalant, vulgar, uninhibited persona was replaced with an intact, consistent personality (Sacks, 1985). Additionally, expected passive, experiential hallucinations of memories were replaced by tormented, vivid ones in which the patient hadn’t just watched but actually re-performed his victim’s murder (Sacks, 1985). As for the exact reason behind the patients amnesia and then sudden recovery of his murderous memories, after sustaining his traumatic brain injuries, was never officially discovered (Sacks, 1985).

Summary by Michelle Paul, Introduction to Neurobiology, University of Michigan-Dearborn, Fall 2015

References

Boksa, P. (2009). On the neurobiology of hallucinations. Journal of Psychiatric Neuroscience, 34(4), 260-262.

Teeple R.C., Caplan, J. P. & Stern, T.A. (2009). Visual hallucinations: Differential diagnosis and treatment. Primary Care Companion Journal of Clinical Psychiatry, 11(1), 26-32.

Schott, G. D. (2007). Exploring the visual hallucinations of migraine aura: The tacit contribution of illustration, Journal of Neurology, 1690-1703.