Persistent organic and psychogenic syndrome following prolonged insulin coma

Conclusions

• 1. A case of combined organic and functional amnesia as a complication of prolonged insulin coma has been reported.

• 2. The unusual features of this case have been emphasized from the standpoint of the persistence, the nature of the functional component and the inaccessibility of the amnesia to well-accepted therapeutic procedures.

• 3. Although the literature reveals conflicting views, it might appear that irreversible organic changes after protracted coma are more frequent than implied.

• 4. The amnesia in the writers' case gave evidence of a marked emotional component. It is felt by the writers that the role of this factor may have been overlooked in other reports and should be further studied, particularly in the face of recent investigations of emotion in connection with normal and pathological variations of memory.

• 5. The value of amnesia as a repression mechanism has been well illustrated. It is possible in this case that the previous paranoid psychosis has been submerged within the symptoms and behavior disturbance of the amnesia. Perhaps this is responsible for the resistance of the patient to usual methods of treatment.