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A 72-Year-Old Man Is Evaluated in the Emergency Department Due

Question 455

Multiple Choice

A 72-year-old man is evaluated in the emergency department due to sudden onset memory loss. The patient was partying with his family when he suddenly started having abnormal behavior. He was confused and kept asking repetitive questions. He does not have any other neurological deficits, headaches, or any other symptoms. The patient is known to have hypertension, diabetes mellitus, and migraine. Blood pressure is 136/84 mm Hg and pulse is 80/min. Neurological examination shows that the patient is conscious. He looks confused and keeps asking " Where am I?, What happened?"He knows his name, his date of birth, and where he lives. He recognizes his family members and is aware of everything around him. He can not retain the name of the hospital or the doctor's name. He can not recall objects after several minutes. There is no dysarthria or aphasia. Cranial nerves examination is normal. Motor, sensory and cerebellar exams are all normal without any significant findings. CBC and the chemistry panel are normal. The drug screen is negative. Radiological imaging does not show any abnormalities. 5 hours later, the patient recovered and returned to normal condition spontaneously. Dysfunction of which of the following structures explain the patient's symptoms?


A) Arcuate fasciculus
B) Hippocampus
C) Nucleus accumbens
D) Piriform cortex
E) Pontine reticular formation

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