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The Man Who Has Just Woken Up: A Twenty Year Follow Up Study.
Journal of the International Neuropsychological Society 12(S1): 83
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CW survived Herpes Simplex Viral Encephalitis in 1985. He was left with extremely severe amnesia. For the past twenty years he thinks he has just woken up and this is one of the major themes in his conversation. He also records this moment of just awakening in his diary and has done so many times each day over the years. Although his scores on standardised memory tests have changed little since he was first assessed and he has failed to learn new linguistic terms such as 'e-mails' and 'mad cow disease' that have entered the English language since the onset of his amnesia, there have been improvements in his behaviour and his mood. This paper addresses four issues. First we establish the stability of CW's episodic memory impairments since he was assessed in 1985 a few months after his illness. Second, we consider the almost total lack of new semantic learning when this is assessed in a standardised way (his wife, however, can elicit some new semantic knowledge when she asks leading questions). Third, we look at his implicit memory which appears to be relatively intact given that he can benefit from an errorless learning procedure. The fourth and final issue addresses CW's response to rehabilitation. Given the severity of his amnesia and the fact that he has additional cognitive difficulties, the most effective rehabilitation approach is that which involves modifications to CW's physical and verbal environment. These are described and considered within a recent model of rehabilitation.