Retrograde Amnesia Associated with Fornix Lymphoma

petitively, often forgetting orders from customers, and would have his employees to roast sesame too much without considering the size of the order. The family thought he seemed strange because he showed no anger when one of his employees, who had worked for him for more than 10 years, moved to a neighboring mill without telling him. His medical history was remarkable for a small infarction of the posterior limb of the right internal capsule with consequent mild left lower extremity weakness 17 years previously as well as for medication-controlled diabetes mellitus arising 3 years earlier. On examination, the patient appeared alert and cooperative but unaware of his memory deficits. He correctly answered questions on personal information, such as his social security number, telephone number, and home address. However, he could not remember recent events, such as how he had visited the clinic and what he had eaten for lunch 1 h before. On MiniMental Status examination, he could not recall 3 words that he had registered only a few minutes before, scoring 20/30 due to additional problems with orientation in time and place and the last step of the Serial Seven Test. The severity and content of cognitive decline were investigated by detailed neuropsychological tests using a standardized battery called the Seoul Neuropsychological Screening Battery [5] . The patient’s Dear Sir, Fornix is a principal tract of the Papez circuit, interconnecting the hippocampus with the anterior thalamic nuclei directly or via the mammillary body. A fornix lesion disconnects the memory circuit that runs from the temporal to the frontal lobe, causing severe anterograde amnesia [1–3] . Memory impairment in those patients was characterized by anterograde amnesia, recognition better than recall and preserved procedural memory. To our knowledge, of 4 reported cases with a localized fornix lesion [1–4] , only 1 patient was described having memory deficits for a retrograde event [4] . However, the patient retained the ability to recall past events, while only confusing their temporal order. We evaluated a patient who suddenly developed a profound retrograde amnesia and anterograde memory impairment associated with an isolated fornix lesion.