Article Title: Anterograde Amnesia and Psychotic Decompensation Following Temporal Lobe Trauma: A Neurobehavioral Case Study
Volume Number: 1
Issue: 2
Year: 2025
Article Type: Case Report
Author Names: Pukar Gupta*¹, Kamal Hamal¹, Roshni Thapa¹, Pradeep Adhikari¹, Prabhat Kaphle¹, Binita Uchai Thakuri², Rahul Bajimaya³
Page Number: 42-46
PDF: [Download]
DOI: https://doi.org/10.64368/ejcmr.vol.1.issue2.1
Affiliations:
¹National Health Action Force, Nepal
²T.U. Teaching Hospital, Nepal
³Department of Psychiatry, Patan Academy of Health Sciences, Patan Hospital, Nepal
*Correspondence: Dr. Pukar Gupta, National Health Action Force, Nepal; Email: drppukar007@gmail.com
Keywords: Traumatic Brain Injury; Temporal Lobe; Anterograde Amnesia; Post-Traumatic Psychosis; Neuropsychiatry; Cognitive Rehabilitation
Abstract:
Background: Traumatic brain injury (TBI) can precipitate neuropsychiatric syndromes, including psychosis and profound memory disturbances. These complications, especially with delayed onset, are often underrecognized in clinical practice.
Case Presentation: We describe a 27-year-old male who developed severe anterograde amnesia (MoCA score 18/30 with deficits in visuospatial/executive and delayed recall domains) and psychosis (BPRS elevations in conceptual disorganization, suspiciousness, and grandiosity) three weeks after a motorcycle-related TBI with a right temporal bone fracture and parietal contusions. Imaging confirmed hippocampal involvement. He was treated with risperidone, escitalopram, and systematic cognitive rehabilitation, resulting in ~70% improvement in psychosis over six months, although memory problems persisted.
Discussion: Temporal-parietal lesions can interfere with hippocampal-cortical and mesolimbic networks, elucidating the simultaneous presence of amnesia and psychosis. Secondary neuroinflammation and network remodeling may lead to delayed psychiatric symptoms. This case exemplifies the diagnostic difficulty in distinguishing post-traumatic psychosis from underlying psychiatric disorders and emphasizes the necessity for extended neuropsychiatric surveillance.
Conclusion: Clinicians should maintain vigilance for delayed-onset psychiatric symptoms after temporal lobe injury, and early multidisciplinary rehabilitation should be prioritized to optimize outcomes.
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