Hypomnesia - symptoms, diagnosis and treatment

Memory impairments are very diverse and do not always arise as a result of internal factors (poor vascular conductivity, neuralgia). Simple overwork can provoke some kind of disorder. The most common memory loss is hypomnesia.

At the same time, the patient perfectly remembers all the important dates in his life, the names of relatives and friends. Problems arise with reproducing detailed information about the events of previous days.

In some cases, the condition may be accompanied by anekphoria, when a person cannot remember basic words, or even names, without prompting from another person. This feature may sometimes be observed when patients better assimilate visual information and poorly remember information by ear. It also happens the other way around.

The progress of violations should be monitored with special attention and responsibility. Disease progression is often observed. The result can be a complete disruption of all types and processes of memorization - amnesia.

The table shows the characteristics of memory impairment

With brain injuries, retrograde amnesia can occur, which is characterized by memory loss associated with the moment it was received. In this case, the patient can clearly remember the events that happened before the injury.

Anterograde amnesia can occur when there is a period of time immediately after the injury.

Classification

Types of memory impairment can be divided into several components:

• Amnesia. Memory in this form is presented in the form of a complete loss of any life episode, inability to perform one or another type of activity, loss of skills that took place at the time of the traumatic event. A person may not know who he is, where he lives and/or may not remember what happened to him. Amnesia is divided into retrograde and anterograde. With the retrograde form, the patient is unable to remember what happened before the attack of amnesia. With anterograde – after;
• Hypomnesia - decreased memory and reproductive function; both short-term and long-term memory may suffer;
• Anekphoria is a frequent accompaniment of hypomnesia, although it is distinguished as a separate type of memory impairment. Represents the inability to reproduce information without others when necessary. In other words, “it’s on the tip of your tongue” specifically about people with this disease. Anekphoria is not always a pathology, sometimes it occurs as a consequence of physical and/or mental fatigue;
• Hypermnesia - exacerbation of memory, can be physiological (for example, in students during a session) and pathological (alcohol and drug intoxication, bipolar disorder, schizophrenia);
• Paramnesia is a false memory characterized by a person’s perception of previously unseen objects as familiar.

Hypomnesia

Hypomnesia is a decrease in various forms and types of memory, often progressing at different rates to the degree of amnesia, including systemic. The increase in hypomnesia, points out V.M. Bleicher, is characterized by a well-known sequence. Initially, the weakening of memory concerns voluntary reproduction. Then the retention of information in memory comes to the fore, and only after that does the memorization of current impressions suffer.

The disorder primarily concerns reference information that cannot be systematized and included in the patient’s existing cognitive structures (names, surnames, titles, terms, dates, phone numbers, faces, etc.). Accordingly, the clinical diversity of hypomnesia is quite large. It is important to note that the first signs of memory decline are determined only subjectively; testing in this case does not give definite results. It is also worth paying attention to the fact that by memory loss, patients often mean attention problems. Clinically, the following variants of hypomnesia are more or less clearly distinguished.

1. Disorder of selective reproduction - a decrease in the ability to quickly recall well-known facts. For example: “The name of a long-known person flew out of my head. Other names appear in your head, any, but not what you need. Sometimes it becomes so inconvenient that I don’t engage in conversation or try not to mention this name... I couldn’t suddenly remember my own phone number... My memory jammed, I suddenly forgot the name of my street... My memory is slipping, they asked my daughters’ birth dates, but I’m lost, I can’t remember , and that’s all here... At the lecture I began to forget some terms, they’re floating around my tongue, but I can’t remember... My memory for faces has become worse, I meet a person, I know that I should remember him, but I can’t remember who he is.” Active efforts to remember forgotten things are often unsuccessful; they seem to only interfere with reproduction, diverting attention from the search for the key stimulus. Somewhat later, the forgotten memory appears in consciousness as if by itself. In some cases, this decrease in memory is combined with a clearly presented symptom of thought loss.

2. Anekphoria - the inability to remember well-known things without outside help. It resembles the previous disorder in that the patient temporarily or forever seems to lose the skill of remembering, but it looks a little different. Thus, a patient, after suffering meningoencephalitis, complained of memory loss and fear of going crazy: “I forgot the names of the people closest to me, not to mention my acquaintances, I can’t remember what people I know look like, where I live, my phone number and much more.” , what I know, I should know, my thoughts are always spinning about the fact that there is no memory. It seems like I’m about to remember it, but I can’t.” Memories gradually returned to the patient, but only after she was helped by reminders. After that, she could independently remember what she had forgotten.

3. Decrease in chronological memory - weakening of the ability to remember, as well as to recall the location and sequence of events in time, including events of personal biography.

4. Decreased spatial memory - weakened ability to remember and reproduce spatial relationships. For example, remember and remember the route of transport in the city, especially if it is an unfamiliar city.

5. Decrease in musical memory - weakening of the ability to remember and reproduce musical images. Complaints about this can be found among musicians.

6. Decreased memory for fresh thoughts - a weakening of the ability to memorize and recall the fruits of one’s own creative imagination, which is especially painful for people of a creative nature.

7. Decreased memory for faces - a weakening of the ability to remember and remember the faces of surrounding people, as well as their images. Realizing this fact, the patient, for example, begins to greet everyone he meets, assuming that in this place there is a high probability of meeting a familiar person. He also notices that in a certain place he recognizes a familiar person, but may not recognize him somewhere on the side.

8. Decreased memory for colors - weakened ability to remember and remember the colors of objects (color of eyes, hair, clothes, etc.). The list of hypomnesia options can be continued further.

9. Decreased memory for what has been done - a weakening of the ability to remember and remember what has already been done or said. Such patients can talk about the same thing several times to the same person, make the same purchase, wash themselves again, wash the floor in the apartment, etc.

10. Dysmnesia - disproportionality in the degree of memory loss for certain impressions. Most often, this is exactly what happens when diffuse memory loss unequally affects one or another type of memory. Symptoms of local hypomnesia may indicate the possibility of developing systemic amnesia in the future.

11. Moral hypomnesia - decreased ability to remember and update ethical norms and rules of social behavior. Characteristic of some types of psychopathy. A critical attitude towards hypomnesia, as well as towards systemic amnesia, usually remains. Moreover, awareness of hypomnesia can be quite painful. Patients often take measures to hide the fact of memory loss from others and somehow compensate for it (writing notes, knitting “knots for memory”, reminders with crosses on the palm, etc.; some patients write and leave inscriptions on sheets of paper in a visible place about what they should do).

Hypomnesia is observed in states of asthenia, adynamia, apathy, abulia, depression, stupor, as well as in the clinical picture of local and diffuse brain damage of various origins. Age-related memory decline is not hypomnesia, although the distinction is difficult to make.

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Causes

The causes of memory impairment are varied and include:

• Prolonged stress exposure;
• Functional mental disorder (neurosis);
• Hypovitaminosis;
• Heredity (anomalies in the development of blood vessels, the spine => insufficient blood flow to the brain => hypoxia => memory impairment);
• Somatic diseases;
• Infections;
• Trauma to the skull and brain (usually short-term memory loss at the time of stress);
• Mental illness (depression, bipolar disorder, schizophrenia);
• Dementia of various origins;
• Pathology of the vascular bed of the brain (atherosclerosis in elderly and elderly people);
• Drug or drug abuse;
• Alcohol intoxication (alcoholic delirium is accompanied by impaired short-term memory, the patient is disoriented in space, cannot remember anything from his life, after detoxification therapy the condition normalizes, but there is no memory at the time of the attack (amnesia));
• Organic brain damage.

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Causes

Causes of hypomnesia:

1. Vascular – weakening of oxygen supply to the brain due to atherosclerosis.
2. Mechanical – external force on the brain, head injuries.
3. Toxicological – decreased brain function due to chronic alcohol consumption, smoking and inhalation of volatile substances, fumes of certain medications.
4. Age-related – senile dementia, decreased intellectual abilities acquired during life.
5. Organic factor – neoplasms of oncological and parasitic etiology or bacteriological origin.
6. Genetic factor – hereditary diseases, mental retardation.
7. Psychological factor – chronic depressive states, stress, overwork, apathy.
8. Nutritional factor - an imbalance between the quality and quantity of substances consumed by the body, a lack of fat-soluble vitamins, phosphorus, magnesium, zinc, etc.
9. Infections of viral or bacterial origin, with febrile conditions and damage to the membranes and tissues of the brain.
10. Mental factor - mental abnormalities or neurological disorders, epilepsy, vegetative-vascular dystonia.
11. Concomitant diseases - hypertension, liver cirrhosis, diabetes mellitus, renal failure.

Memory impairment as a local brain lesion

Luria A.R. – Soviet neuropsychologist identified two types of mnestic memory defects:

• Modality-nonspecific memory impairments. When the medulla oblongata is damaged, changes in consciousness, sleep, memorization, storage and reproduction of information are observed. If there is a disorder in the hippocampus, short-term memory suffers; a person is unable to remember what happened to him a few minutes ago;
• Modality-specific memory impairments. If the temporal lobe is damaged, there will be a significant decrease in the memorization of words, and the parieto-occipital lobe will experience the inability to reproduce objects and/or phenomena out loud, although the person is aware of the meaning of the words (sometimes this occurs as a consequence of moral or physical violence).

What it is?

Hypermnesia is a psychopathological symptom of quantitative memory impairment , in which one of its three components - memorization, storage and reproduction - is impaired.

The first two work normally, but playback is abnormally aggravated. The duration of such a disorder can be either short-term or permanent.

The phenomenon is partly explained by the excessively easy excitability of neurons, as a result of which, against the background of even a slight emotional upsurge, a person can easily retrieve any, even the most ancient, information from the memory archive.

The process of forgetting in this disorder practically does not function , which causes quite a lot of discomfort in some patients about this. The presence in the memory of so many past events with the smallest details distracts a person from current reality.

Most often, hypermnesia affects mechanical (remembering information only in its original form) and emotional memory - experienced vivid feelings about a particular occasion. But such a phenomenon almost always occurs against the background of confused consciousness. In particular, a gross violation of the logical sequence of events and selective reproduction.

In addition, in most cases, hypermnesia occurs in patients with manic syndrome, which is characterized by mental and motor agitation with inappropriately elevated mood.

In psychiatry, this condition is classified as a non-productive disorder . A huge number of completely useless memories has an extremely detrimental effect on the productivity of thinking, which progressively decreases. It is this fact that does not allow hypermnesia to be perceived as simply a phenomenal memory and an amazing individual personality trait.

This pathology is considered on a par with hypomnesia, amnesia and paramnesia - the main memory disorders.

You can read about dysmnesia, another memory disorder, in this publication.

Identifying the cause

To identify the cause of memory loss, a person needs to undergo a comprehensive examination, since hypomnesia can be caused by both a neurotic state and much more serious diseases. First, you need to collect a thorough medical history, check with the patient for bad habits, past trauma, heredity, and chronic concomitant pathology. An MRI, ultrasound, and EEG must be performed; if no changes are detected, then a CT scan of the brain can be performed. MRI does not always show bone tissue diseases, so CT is an additional examination method. If the anamnesis and the data obtained do not give a positive result for an organic lesion, then it is worth excluding the mental component. Often, memory loss can be a consequence of schizophrenia and psychoses of various origins. Therefore, a psychiatrist should also work with such patients.

Making the correct diagnosis

First of all, the doctor interviews the patient, who must describe his condition and its difference from when, in his opinion, there were no changes in memory.

Also, various tests are always used in order to more reliably detect the objective presence of violations. Tests with pictograms, memorizing text, as well as the “10 words method” proposed by the Soviet psychologist Alexander Luria are common.

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The following studies are prescribed:

• the neural activity of the brain is studied using EEG;
• CT (computed tomography) and MRI (magnetic resonance imaging) are performed;
• Ultrasound of organs;
• electrocardiogram.

Urine and blood tests are also prescribed to verify the absence or, conversely, the presence of somatic diseases, which could lead to a failure.

It is extremely important for the doctor to make sure that the patient has hypomnesia and not some other disease, especially of a mental nature. For example, depression and neurosis have the same symptoms, but their treatment has nothing to do with the treatment of hypomnesia.

Diagnostics

Memory impairment can be diagnosed using a flashcard test, which assesses the patient's ability to remember and recall items depicted on paper. This test is carried out in two episodes, the first of which will involve 30 cards, where the doctor shows them to the patient at intervals of several seconds. The subject will then have to show the doctor the images that were among the objects drawn. After a short break, the second episode follows the same principle. Normally, a healthy person should show 20 or more cards used in the test.

By analogy, a hearing test is carried out, where the doctor lists 30 objects out loud, where the patient, again, must indicate 18-20 words, which will be the norm.

Using the memorization method, you can find out how well the subject perceives words by ear. The doctor reads 10 words with two syllables, and then repeats them 2-3 times. After half an hour, he again asks the patient to list the necessary words. At the same time, the doctor writes in a notebook, where he indicates the number of correct and incorrect answers.

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Clinical picture

Memory is a cognitive process associated with preserving, remembering and reproducing a person’s past experiences.

There are several types of memory: motor, emotional, figurative, verbal-logical, involuntary, semantic. Based on the duration of information storage, short-term, long-term and operational memory are distinguished.

The processes include: memorization, imprinting, reproduction, recognition, recollection, preservation. The joint activity of these main components guarantees its successful development. If a particular species or process begins to suffer, this entails a number of other disorders. Among the processes one can also trace such as forgetting.

It is characterized by a gradual decrease in the ability to recall material. Hopomnesia is a similar disorder. Hypomnesia can be general or partial. In addition, it can occur as a temporary phenomenon in depressive states and as a persistent and even progressive pathology.

There are many reasons for hypomnesia.

1. The main cause is brain injury. Damage to any part of it entails violations. For example, damage to the temporal cortex entails a disruption in the process of imprinting and storing figurative information.
2. Brain tumors.
3. Vascular diseases of the brain, such as atherosclerosis. The disorder can also occur after a stroke.
4. Bad habits such as alcohol and smoking interfere with the conduction of oxygen and nutrients to the brain. Poisoning of the body occurs.
5. An acquired decline in intelligence—dementia—usually occurs in old age and may be accompanied by hypomnesia.
6. Oligophrenia. With any degree of mental impairment, memory impairment towards hypomnesia is observed.

The memory of these people is inactive and unproductive.

7. Epilepsy.
8. Hypertensive disease.
9. Vegetative-vascular dystonia.
10. Some medications can cause partial amnesia.
11. Taking psychotropic substances leads to a person’s fragmentary recall of life events.
12. Being under prolonged stress provokes hypomnesia. This may also include depression or anxiety disorders.
13. Any physical illness can temporarily impair memory.
14. Overwork and lack of vitamins.
15. Mental illnesses. The peculiarity in this case is that the person first forgets events that happened recently. Then he forgets events that happened a long time ago.

Treatment

Therapy for hypomnesia is aimed at the root cause of the disease. If episodes of memory loss are isolated, and you note a connection with some traumatic or other stressful factor, then this may be a kind of “defense mechanism.” It’s not for nothing that victims of violence forget, remember things poorly, or lose partial memory. The psychological block can pass independently or after a conversation with such a person by a psychotherapist and/or psychologist. In other cases, treatment consists of a whole range of medications depending on the etiological factor. For mental illnesses with apathy - antidepressants, for manic syndrome - mood stabilizers, for schizophrenia - antipsychotics, tranquilizers. For astheno-neurotic status, sedatives or mild anti-anxiety medications and B vitamins are used. Atherosclerotic changes in blood vessels are treated with lipid-lowering drugs in combination with angioprotectors and surgery if necessary. Psychoses and, as a consequence, hypomnesia during alcohol and drug intoxication disappear after competent detoxification therapy and sorbent therapy. Oncological diseases - radiation, radionuclide, chemotherapy, surgery.

What does this look like in real life?

As stated above, there is an extensive list of reasons leading to hypomnesia. Therefore, its various forms can also manifest themselves in different ways, but there are some common signs.

Most often, memory is weakened locally, and not generalized. This means that some of its functions can suffer greatly, while others remain unharmed. This especially applies to the ability of memory to store and reproduce stored information. In addition, there are situations when the patient cannot remember something, but after some time the same information is recalled with ease.

One of the main manifestations of the disease is frequent cases when a person says something to a friend, and after a while forgets what exactly he said.

Therefore, among the common symptoms of hypomnesia are:

• weakening of the sense of time;
• mechanical memory is more susceptible to disease than verbal-logical memory;
• it is difficult or even impossible for the patient to reproduce the chronology of recalled events;
• new incidents are remembered with greater difficulty than before.

In schoolchildren, hypomnesia can manifest itself in problems with retaining in memory material read or said by the teacher. Preschoolers with this disease have trouble remembering even short poems.

How to treat?

The treatment regimen is built on the basis of test results, the results of the examination completed and the established diagnosis . All basic therapy comes down to the possible elimination of the primary disease and most often requires a hospital stay.

In the most common version, abnormally heightened memory accompanies manic syndrome. In this case, it is necessary to solve 3 main tasks: to stop the root cause, stabilize the patient’s condition and prevent possible relapses.

Relief is carried out using psychotropic tranquilizers based on lithium (lithium hydroxybutyrate) . For a faster effect, the drug is sometimes combined with antipsychotics. And in a particularly acute stage of manic psychosis, Finlepsin is additionally prescribed.

Antidepressants with a sedative effect help stabilize the mental state. Therapy of the depressive phase often involves the appointment of Tsipramil, Transamine, Nuredal or Fluoxetine.

Prevention of relapses takes place on an outpatient basis and consists of adjusting the dosages of prescribed medications. To a large extent, its effectiveness depends on strict adherence to the dosage schedule without any independent cessation of treatment.

If hypermnesia was provoked by drug or alcohol intoxication, a course of detoxification procedures is often sufficient to return the psyche to normal . When abnormal memory aggravation occurs during treatment with psychotropics, the dosage of the drugs is revised, and the natural process of forgetting begins to function as before.

Types of this memory disorder

Hypermnesia

Hypermnesia is an involuntary memory activity in which the ability to reproduce long-standing or irrelevant past events or experiences increases.
At first it may seem that this indicates phenomenal memory, because a person can remember even the most insignificant data.

But such memories interfere with the normal functioning of the thought process, the memorization of relevant information is weakened, and the voluntary processes of memorization and reproduction are disrupted. This phenomenon is observed for a short time, fragmentarily, is not reproduced at will, and is unstable .

A similar pathology can be observed when taking narcotic and psychoactive substances (opium, LSD), alcohol, in hypnotic sleep, with certain mental illnesses (schizophrenia, manic states, psychopathy, epileptic seizures), and with fever.

Hypomnesia

Information partially falls out of memory, manifested by a decrease in the ability to remember , retain and reproduce specific events or facts.

With this type of disorder, only vivid memories and impressions are remembered. Dates, terms, names are poorly reproduced.

Hypomnesia is observed in neurological disorders (vascular, traumatic and atrophic processes of the brain), intellectual disorders (dementia), and drug addiction. May occur in people who are tired or overworked. Is the norm for most older people.

Amnesia

Loss of memories, their disappearance from life, inability to tell the necessary information that took place in a specific period of time.
Amnesia occurs due to traumatic brain injury, chronic poisoning, hypoxia, cell necrosis, alcoholism and other reasons.

There are four classifications of amnesia:

1. In relation to the period undergoing amnesia to the period of illness (retrograde, congrade, anterograde, anteroretrograde).
2. According to dysfunction (fixation, perforation, anekphoric).
3. According to dynamics (progressive, stationary, regressive, retarded, total).
4. By object (affectogenic, hysterical, scotomization).