The work rehabilitation of a herpes simplex encephalitis patient with anterograde amnesia

A description is given of the assimilation back into the work-force of a 28-year-old female law graduate with amnesia following herpes simplex encephalitis. This case study describes the patient JR and the preparation and training required for her eventual gainful employment as a part-time assistant librarian in the library of a law firm. Her return to work was achieved despite the patient also suffering from complex partial seizures and insulin-dependent diabetes. The difficulties encountered in training are described with the importance of errorless learning and the breaking down of tasks into procedural routines appropriate for nondeclarative memory. The extensive use of environmental cues including a procedural folder led to habit learning and unsupervised work in filing, checking in books on a computer, and shelving of books. Apart from the therapeutic intervention, the project's success may be attributable to preliminary diary training, relatively intact semantic memory for information learned prior to the disease onset, the use of a familiar work environment, strong family and rehabilitation support systems, and the personality characteristics of the patient.