POSTTRAUMATIC-STRESS-DISORDER WITH NEUROGENIC AMNESIA FOR THE TRAUMATIC EVENT

Patients who meet established criteria for head injury with neurogenic amnesia occasionally also present with symptoms of Posttraumatic Stress Disorder (PTSD). However, at present, no generally acceptable means is available to diagnose PTSD when the causal event also has resulted in neurogenic amnesia. The reason for this diagnostic dilemma is that the definition of PTSD appears to imply memory for the trauma that at least potentially is accessible to consciousness. Contemporary understanding of the diverse nature of memory and its neurological substrate has provided a new basis for clarifying the co-occurrence of PTSD and neurogenic amnesia for the trauma. We present two cases of PTSD with neurogenic amnesia and a theoretical framework that allows sensible dual diagnosis. Dual diagnosis should lead to a rational therapy for PTSD in head-injured patients.