17 ms·

After simple dental surgery, a man lost his ability to form new memories

333 points by smoyer 6y ago

ccaleb 6y ago
That this happened from a local anesthetic is very, very strange. Before reading the story I wondered what combo of drugs they'd used to knock him out, because those can be risky. While I don't see any direct relation, this article makes me recall another discussing gum disease prevalence in Alzheimer patients.
- kozak 6y ago
  Toxic effect of an accidental intravascular injection? Who knows where that vessel went...
- elric 6y ago
  I have a friend who suffered permanent nerve damage from a simple local dental anaesthetic. Given a large enough sample size, I guess unlikely things will crop up?
  - rscho 6y ago
    Peripheral nerve, yes. But not brain damage I guess? Yes, that's a possible and well-known complication, although quite rare.
SketchySeaBeast 6y ago
Hopefully something can be learned from his experience, but what a tragedy. It seems like a waking nightmare.
chrisacky 6y ago
Christopher Nolan did the screenplay for Momento which was one of my favourite films a few decades back about a guy who has anterograde amnesia[1]. [1] : https://en.wikipedia.org/wiki/Anterograde_amnesia https://en.wikipedia.org/wiki/Anterograde_amnesia
- user_ 6y ago
  Christopher Nolan based the screenplay for Memento (which he directed, as well) on a short story[1], Memento Mori, written by his brother Jonathan. [1] https://www.londonscreenwritersfestival.com/assets/Memento-Short-Story-by-Jonathan-Nolan.pdf https://www.londonscreenwritersfestival.com/assets/Memento-S...
jkinudsjknds 6y ago
The gums are full of nervous tissue. It's a straight line to the brain.
im3w1l 6y ago
What a fascinating case - that he is even unable to learn procedural skills. Speculating wildly here, but with learning being at the very core of what neurons do, the issue seems "low level" enough that it might even show up if you put a tissue sample in a petri dish.
codetrotter 6y ago
> he wakes up every morning believing he is still in Germany in 2005, waiting to visit the dentist That’s some real-life eternal Groundhog Day stuff right there. Hellish :( > Today, he only knows that there is a problem because he and his wife have written detailed notes on his smartphone, in a file labelled “First thing – read this”. This is more positive, and reminds me of the movie 50 First Dates with Adam Sandler. Also, am glad to hear he has someone in his life that is by his side.
- the_af 6y ago
  It could also remind you of Memento, though that brings you back to "hellish" ;)
  - bmlzootown 6y ago
    50 First Dates... Much more fitting comparison, at least in terms of waking up to the "same" day over and over (as she too had some sort of amnesia).
    - the_af 6y ago
      To be fair, I haven't watched 50 First Dates so you might be right! In Memento, Leonard also wakes up each day to the "same" day because he (arguably) has anterograde amnesia and cannot form new memories. He keeps tracks of new developments he wants to remember by writing on his own body and on the backs of polaroids (a bit like writing a note with his smartphone! Memento was filmed in 2000, and smartphones didn't exist yet).
      - paranoidrobot 6y ago
        50 First dates is the more romantic story about a guy who meets a girl who has ~~ante-rograde amnesia~~. e: I forgot, in the movie she has a fictitious disease that's sort of like ante-retrograde amnesia, but wipes her memory when she sleeps.
      - wernercd 6y ago
ddlatham 6y ago
What would it take for you to be convinced after you wake up this morning that you had this condition and the year was actually 2035 right now? Rot13 after you've thought of an answer: Abj nfx lbhefrys, ubj uneq jbhyq vg ernyyl or sbe gung gb or snxrq?
- aaomidi 6y ago
  My phone's clock and going to Google.com and being able to load it. Assuming it's still around. If not I doubt it'll fail with a cert error.
  - briefcomment 6y ago
    Imagine waking up and seeing an iPhone for the very first time. In 2005, the latest phone he probably had was some flip phone.
    - SketchySeaBeast 6y ago
      "Ah sweet, what else do we have? Are all cars electric? Did we make a manned flight to Mars? Have we cured cancer?" "Oh, that's about it. We have iPhones now. And to be honest, they are kind of a problem."
    - ilkkao 6y ago
      The article should have explained this in little more detail. Does he have a 2005 phone, probably Nokia Symbian? Or does he actually remember something and can use android or iphone. In the first case, a written note in his own handwriting would make more sense I guess.
    - cgriswald 6y ago
      ...and then going outside and seeing an orange sky and all the people wearing masks.
    - mikestew 6y ago
      Imagine you were me in 2005 with an HTC 8125 that had a sliding keyboard with actual QWERTY keys, and I wake up to find that all “smart” phones are black slabs of glass that I’m suppose to poke at with my paws like some kind of animal. I’ve since come to terms with the glass keyboard of my iPhone, but I maintain that it was not progress. Besides, the person in the story was only two years out from seeing an iPhone for the first time, like everyone else at the time.
nindalf 6y ago
@dang could we get rid of the clickbait title? Something more like "Man suffers anterograde amnesia after routine dental surgery"
- smoyer 6y ago
  > clickbait I considered changing the title when I submitted this but went with the HN guidelines that prefer the publisher's title. Admittedly the article's header might be a bit better than the slug in this case (but I was lazy).
- st_goliath 6y ago
  > Something more like "Man suffers anterograde amnesia after routine dental surgery" "... he'll never know what happened next"
- haffi112 6y ago
  It's not clear that there is any causal relationship between the dentist appointment and the resulting events. Possibly this event was bound to happen and it just so happened that the subject was visiting a dentist. At least I hope people won't get even more scared of dentists after reading this... but I guess BBC succeeded in that.
Freak_NL 6y ago
<SCARY DENTIST PHOTO; FULL-WIDTH> Somewhat interesting story <RANDOM PSEUDO-RELATED STOCK PHOTO> More of the story <RANDOM PSEUDO-RELATED STOCK PHOTO> Some more story <RANDOM PSEUDO-RELATED STOCK PHOTO> Some more story <RANDOM PSEUDO-RELATED STOCK PHOTO> (Scroll down to far) <COMPLETELY DIFFERENT STORY STARTS> If this is the future of the BBC (being in the 'future' category of the website), then I'll pass on that.
- MattGaiser 6y ago
  The thing is that everyone does this and everyone is paying to do this (as stock photos are not free). I assume it is passing A/B testing.
  - agustif 6y ago
    If you're cheap there's unsplash though, nice quality for the pricetag (free)
  - vorpalhex 6y ago
    There's a time and place for this technique. I do it on my posts where I'm showing you something as it evolves - usually an electronics project. Long running narratives are usually not the place for this.
  - Doctor_Fegg 6y ago
    Apparently the BBC has a bulk deal with stock photo agencies where they basically get unlimited usage for £££ every year. I found this out when I asked them why they were using a Getty image of Broadcasting House (in a story about BBC office moves) rather than just stepping out into the corridor and taking one...
- sandworm101 6y ago
  Look deeper at the first photo. That isn't even a real dentist. Those are not medical/laser safety glasses. They look like they came out of a carpenter's toolbox. And look at the tool in his right hand (camera left). We have all been eye-to-hook with the various dental implements. That doesn't look like any tool i've ever seen. I think it is a prop, a blunt tool so that actors don't cut themselves. If the BBC is going to use a stock image, at least use the one of a real dentist. (I can forgive the faked scratches on the glasses. That was probably done so we don't see the reflected image of the camera lens.)
not_a_moth 6y ago
I remember Roger Penrose talking about the mystery of anesthetics, how they may target the vast "microtubule" network in the brain, itself a pretty surprising and unknown structure. So little we know I suppose.
- DonaldFisk 6y ago
  In this case, his dentist used local anaesthetic. Penrose was referring to general anaesthetics and their effect on consciousness.
- KingFelix 6y ago
  He spoke last week about it at The Towards a Science of Consciousness conference (Univeristy of Arizona) Stuart Hammeroff and Penrose have the Orc OR Theory of Consciousness. Stuarts an anesthesiologist
aazaa 6y ago
> Since then, he has been unable to remember almost anything for longer than 90 minutes. So while he can still tell me about the first time he met the Duke of York for a briefing at the Ministry of Defence, he can’t even remember where he’s living now; he wakes up every morning believing he is still in Germany in 2005, waiting to visit the dentist. Without a record of new experiences, the passing of time means nothing to him. Today, he only knows that there is a problem because he and his wife have written detailed notes on his smartphone, in a file labelled “First thing – read this”. This almost perfectly captures the premise of the movie Memento.
patorjk 6y ago
> Given the evidence, Burgess instead suspects the answer may be hiding in the thicket of tiny neural connections we call “synapses”. Once we have experienced an event, the memories are slowly cemented in the long term by altering these richly woven networks. That process of “consolidation” involves the production of new proteins to rebuild the synapses in their new shape; without it, the memory remains fragile and is easily eroded with time. I was reading the other day about a study that's checking to see if injecting BDNF [1] into a patient's cochlea will help improve their hearing. In animal studies it helped rebuild broken synapses and led to better hearing. I wonder if injecting the brain with the missing proteins (or as the article refers to them, "ink") would help with the formation of memories? Though maybe this is too simplistic of a view. [1] https://en.wikipedia.org/wiki/Brain-derived_neurotrophic_factor https://en.wikipedia.org/wiki/Brain-derived_neurotrophic_fac...
jonawesomegreen 6y ago
> Since then, he has been unable to remember almost anything for longer than 90 minutes. ... Without a record of new experiences, the passing of time means nothing to him. Today, he only knows that there is a problem because he and his wife have written detailed notes on his smartphone, in a file labelled “First thing – read this”. I think it would be fascinating to read the "First thing - read this" file on his phone. I can see why they don't go into more detail it would probably be pretty personal info in there. Still as a mental exercise, its interesting to think about what I would write down in that file for myself.
andai 6y ago
I heard that the upper teeth are close to the brain and tooth infections can cross the blood-brain barrier so that was my first thought, but it doesn't seem to be the case here (the transition was instant, the damage doesn't appear to be local or getting worse).
- larrik 6y ago
  This happened to my grandmother. One week she was sharp as a tack. Next week, lit her house on fire to clear a paper jam... Doctor's claimed dementia, turned out to be a tooth infection.
- rscho 6y ago
  teeth abcesses can degrade really fast (like, minutes). root canal infectious migration to the brain is actually the most likely cause here, in my opinion.
iso1210 6y ago
That entire page and no mention of the Adam Sandler/Drew Barrymore film 50 First Dates, which came out a year before and covers a woman who wakes up every morning thinking it's the same day? At the time of release it seemed to be a medical condition that wasn't real, however there have been a couple of instances diagnosed since then.
jawns 6y ago
To me, the most disturbing part of this story came at the very end, where it says that he has just relearned, for the thousandth time, that his children are now in their late teens and early 20s -- whereas his last memory of them was as little kids. If that were me, and I were just informed that my own little children had essentially disappeared, I would likely go catatonic. I mean, in a sense, even though they're still present as young adults, it's as if your children have died. I don't know how a person could cope with being told that even once, much less a thousand times.
- DoofusOfDeath 6y ago
  FWIW, I metaphorically went though that myself, by being overly focused on grad school and professional development while they were young. I would give almost anything to undo that mistake. If you don't mind a suggestion, take lots of video and get lots of audio recording of them. Their little-kid voices don't last forever. And once they're past the obnoxious teenage years, you may find you can't even remember their earlier voices. (AFK to dry my eyes and go give my kids a hug.)
  - bentcorner 6y ago
    > If you don't mind a suggestion, take lots of video and get lots of audio recording of them. Totally agree. The firsts are a source of joy and the lasts make me melancholy.
  - Aeolun 6y ago
    This is probably the best part about ubiquitous smartphones. Making a video is almost always possible. At the same time, I don’t think we should ignore the experience in the moment just to take a video for later.
- fatnoah 6y ago
  That is the part that got to me as well. To see your children, but effectively not know the people they've become as they've grown must be devastating.
- mcphage 6y ago
ChrisArchitect 6y ago
(2015)?! cmon https://news.ycombinator.com/item?id=9833717 https://news.ycombinator.com/item?id=9833717
myself248 6y ago
My memory took an absolute nosedive, not quite this severe but I have tremendous trouble, after being knocked out for a colonoscopy. I've lived in "brain fog" ever since, and my memory is a shadow of what it once was. I've gotten extremely rigorous at writing notes for myself, doing sketches which I never used to need, and otherwise compensating. I hold it together on a professional note, but personal relationships have suffered badly. I guess I need to take better notes about them, which I don't currently do. As horrific as this story is, I guess it's good to know that I'm not alone?
- doublesCs 6y ago
  I never had long-term consequences, but one thing I learned from my one surgery, is that general anesthetics are absolutely brutal.
  - nerdponx 6y ago
    You aren't (or shouldn't be) put under general anesthesia for a colonoscopy. They use "conscious sedation", in the USA typically achieved with intravenous propofol. You are technically conscious, but very sleepy and unable to form memories while sedated. But yes, general anesthesia is really wild stuff. Even more wild when you learn that we don't know how they actually work, other than that they work.
    - AuryGlenz 6y ago
      It also made me giggle right before my colonoscopy, so that’s nice if not embarrassing.
    - taylodl 6y ago
      They gave me a "sedative" for my colonoscopy. They just said it will make me really relaxed and maybe sleepy. I wasn't sleepy at all but boy was I relaxed! I remember laying on my left side, the doctor behind me controlling the scope, and the nurse in front of me but not obstructing the views of the monitors that were also in front of me. I was getting an awesome inside view of my guts! At one point I was feeling some pain and making some noises about it and the nurse told the doctor to hold on, apparently there was a pretty tight turn and she kneaded my guts so they could negotiate it. They did find a polyp and showed it to me on the monitor, TBH you have to have a trained eye to recognize those, so they biopsied it right then an there. The results came back a few days later saying it was benign. Unfortunately since they found a polyp they have me on a five year colonoscopy schedule instead of ten. For those fretting about getting a colonoscopy, like I was, let me tell you it's no big deal. I've had dental cleanings that were more uncomfortable. In fact, there was nothing about my colonoscopy that was uncomfortable. Getting your guts cleaned out in preparation for the colonoscopy? Yeah that's a different story but the actual procedure itself is a big nothing burger.
gattilorenz 6y ago
For another incredible case of retrogade amnesia, check the story of Clive Wearing, the men with a few seconds of memory. Short clip: https://www.youtube.com/watch?v=Vwigmktix2Y https://www.youtube.com/watch?v=Vwigmktix2Y Extended documentary: https://www.youtube.com/watch?v=k_P7Y0-wgos https://www.youtube.com/watch?v=k_P7Y0-wgos I learned of him through neuroscience classes. That was plenty of years ago, and I still think of his condition every now and then. One thing that amazes me is that he keeps stacks of diaries where he keeps erasing the previous entry, adding the current date and time, and writing "first entry I made consciously" (https://youtu.be/k_P7Y0-wgos?t=1113 https://youtu.be/k_P7Y0-wgos?t=1113). But also, it seems that over time he does learn something new, somehow. For example, he can now reliably "predict" the ending of movies he has seen a great amount of times after the amnesia started, without remembering of having ever seen the movie. And, of course, it's touching to see the relationship with the wife.
cblconfederate 6y ago
HM has been such a monumental case in neuroscience, that a case like this would mean a huge shift in the way people think about hippocampus and memory. We already know that his amnesia it was more severe due to parahippocampal areas being removed rather than just hippocampi. Still, he was only one case, upon which thousands and thousands of studies have rested on.
blackbear_ 6y ago
I had a similar experience, when a friend got hit by a car and hit his head when falling. After all due checks were performed at the hospital and I was allowed to see him, his memory would reset every five minutes. He would stare blankly at the wall for a few seconds, then ask the same questions all over again: where am I, what day is it, and so on. After a while we just gave him a piece of paper with a brief explanation of what happened and some FAQs. I must confess, I had some (innocent) fun. Now he's fine, as if nothing happened, and we laugh every time we remember this.
- gizmondo 6y ago
  Happened to me during a soccer game, was gone next morning. I think it's not so rare symptom of concussion, i.e. quite different than what the article describes.
NiceWayToDoIT 6y ago
Recently I watched movie "Brain on Fire" sorry a big spoiler ahead, in it main protagonist a girl had auto-immune disease so one half of brain got inflamed. She was showing symptoms like she had schizophrenia. After fixing auto immune problems and brain inflammation everything return to normal with some after effects. That being said and knowing that root canals can get inflamed and that inflammation can spread trough nerves to brain how lightly is the cause of his amnesia has a similar cause? Neurologist among you what is the brain region that is most probably first to be affected if that would happen?
rscho 6y ago
Why does everyone assume it's due to anesthesia? It's not stated like that in the article, I think. And it's also very unlikely pharmacologically speaking. Could be infection. Could be a random stroke that happened at the just the right time...
newobj 6y ago
(pre-rant: Why do people post medical articles on HN? If you say anything in response to them, you get downvoted because you're not a scientist/doctor/yada yada.) Having said that: people w/ MTHFR mutations are cautioned against nitrous during general anesthesia: https://www.scielo.br/scielo.php?pid=S0034-70942019000600637&script=sci_arttext https://www.scielo.br/scielo.php?pid=S0034-70942019000600637... https://pubmed.ncbi.nlm.nih.gov/18008117/ https://pubmed.ncbi.nlm.nih.gov/18008117/ It's funny, most people, even doctors, don't yet seem to know anything about MTHFR, but my son's dentist knew this (he has heterozygous mutations on 677 and 1298; I am homozygous 677) - so when I brought up MTHFR, she knew what to do - give him kiddie xanax rather than nitrous. I thought I was going to have to fight her about it, but nope. (also: i know this article is about local anesthesia, i'm making a more general comment about anesthetics and complications)
- hackinthebochs 6y ago
  How did you find out about the MTHFR mutation? Does it present with some visible symptoms such that a diagnosis will likely be made?
  - bionhoward 6y ago
    Try a consumer genomics company like 23andme or nebula
- PragmaticPulp 6y ago
  Anything MTHFR-related has become a minefield of bad science on the internet. The amount of misinformation around the MTHFR gene is staggering, not to mention the droves of websites trying to sell various supplements and ebooks to people who are concerned about their MTHFR gene mutations. > Having said that: people w/ MTHFR mutations are cautioned against nitrous during general anesthesia: That's not exactly what those studies are saying. The latter is a single case report of an isolated incident which the authors hypothesized to be related to her rare homozygous MTHFR mutation. The former paper cites the latter paper as one of only two references. Needless to say, the evidence is quite weak. Moreover, the first paper recommends alternative methods that have their own downsides. It's remarkable that people are so quick to assume entire professions have overlooked something so obvious as the MTHFR mutation based on a pair of linked papers. In fact, the latter paper even goes so far as to say they are not advocating for removal of nitrous oxide nor for preemptive screening for the MTHFR mutation.
sliken 6y ago
I ended up on a several hour car ride with an anesthesiologist, he mentioned that Dentists are often grandfathered in, and often end up doing serious procedures without an anesthesiologist involved. So while they are focusing on the procedure heart rate, breathing rate, O2, etc aren't monitored nearly enough. Apparently getting panicked calls from dentists was not unusual. In one particular case a 18 year old woman wouldn't wake up, he helped as much as he could, but she was never the same. Morale of the story, don't let a dentist put you under without an actual anesthesiologist involved.
- tachyonbeam 6y ago
  So I guess what might be going on here, is partial brain tissue death from lack of oxygen, or something like that? Holy fuck.
  - winrid 6y ago
    Yeah, after reading this I'll never go under without an anesthesiologist.
- rscho 6y ago
  Well, I'd say monitoring is the minor issue in such cases. The real issue is that when something happens, and something will happen someday over the duration of a career, anesthesiologists are basically the only ones who can really help. Unfortunately, you have to pay for anesthesia and they will want to do things their way so that's very annoying for other specialists.
- disown 6y ago
  > Morale of the story, don't let a dentist put you under without an actual anesthesiologist involved. An anesthesiologist says anesthesiologists are indispensable? How shocking. There are plenty of horror stories when anesthesiologists are involved as well. The moral of the story is whenever possible, try and not to be put under.
  - sliken 6y ago
WhiteWestie 6y ago
My cousin lost her sense of taste after a routine dental surgery, removing her wisdom teeth. My sister also lost hers while removing her wisdom teeth (different dentist) but recovered after a few weeks taking some vitamins prescribed by the dentist.
- cableshaft 6y ago
  The front of my tongue no longer tastes, and barely feels anything, after dental surgery (probably local anesthetic from a root canal). I can still taste in the back of my tongue, thankfully, but my sense of taste overall has definitely diminished. I feel sorry for your cousin. I had gotten the local anesthetic several times without issue, it was just that one time that I got unlucky. Supposedly if the sense of taste doesn't come back after two years it's not likely to, so I guess this is my life now.
sradman 6y ago
The paper Profound anterograde amnesia following routine anesthetic and dental procedure [1] > Anterograde amnesia caused by bilateral hippocampal or diencephalon damage manifests in characteristic symptoms of preserved intellect and implicit learning, and short span of awareness with complete and rapid forgetting of episodic material. A new case, WO, 38-year-old male with anterograde amnesia, in the absence of structural brain changes or psychological explanation... amnesia onset coincided with anesthetic injection and root canal procedure, with extended vasovagal-like incident. > WO attended a routine dental appointment for root canal treatment at 13:40 hours. He was injected with the anesthetic, Citanest with Octapressin 3% just prior to the beginning of treatment. He wore tinted dental glasses, obscuring a view to his level of responsiveness. The procedure was completed at 14:30 hours, and at this time it became apparent that WO was pale and faint, and could not get himself up when re-positioned from the supine to the upright position. So after the 50 minute dental surgery, the patient was still suffering from something similar to an extended fainting spell (vasovagal syncope). This resulted in permanent brain dysfunction isolated to the parts of the brain associated with forming long-term memory without any measurable structural damage. A weird but fascinating puzzle. Question 1: does oxygen deprivation in the brain result in measurable structural damage? Question 2: can an anaesthetic selectively impact one artery servicing the brain? [1] https://pubmed.ncbi.nlm.nih.gov/25978125/ https://pubmed.ncbi.nlm.nih.gov/25978125/
novia 6y ago
Something I want to know, that no article seems to mention is, which tooth? If theoretically there is a memory mechanism external to the brain, wouldn't this offer a hint to where to look for one?
- csomar 6y ago
  My guess is this is probably caused by the anesthetic. Maybe it somehow got its way to his brain and damaged his hippocampus. That they didn't find any brain damage, doesn't mean he didn't get any brain damage. https://c8.alamy.com/comp/2AA7CBF/an-anatomical-cross-section-of-a-head-showing-teeth-arteries-and-veins-coloured-engraving-by-a-tardieujpg-2aa7cbf-2AA7CBF.jpg https://c8.alamy.com/comp/2AA7CBF/an-anatomical-cross-sectio...
  - rscho 6y ago
    My guess as an experienced anesthesiologist is that the most likely cause is infection. Anesthesia is far behind in terms of probability, although not 100% excluded. Even a random stroke would probably be more likely.
deleted 6y ago
[deleted]
chrischen 6y ago
I’m curious since this happened in Europe, is that dentist liable for malpractice? Who has to pay for his subsequent medical bills / loss of employment?
sohkamyung 6y ago
John Varley wrote a story about this kind of medical condition: "Just Another Perfect Day" [1]. [1] https://www.lightspeedmagazine.com/fiction/just-another-perfect-day/ https://www.lightspeedmagazine.com/fiction/just-another-perf...
mickelsen 6y ago
A year ago, after getting a nasal cautery (third one in a year in a nostril that kept being problematic) I started getting spasms between my neck and shoulder, it happens whenever I'm laying on the bed on that side. Massage makes it worse, but that's also my "bad side" when it comes to muscle knots, even before the little surgery. Stopped wearing a backpack since then to see if that was the culprit, cut down on caffeine, MRI & Angio show up OK, but still no go. Maybe the ENT messed up my nerves? Asking for a friend.
ilkan 6y ago
"Despite their necessity in modern medicine, scientists aren't sure exactly how anesthetics work. The best theory suggests that they dissolve some of the fat present in brain cells, changing the cells’ activity. But, the precise mechanisms remain unknown." Perhaps it works by stopping the protein synthesis... Permanently in his case https://www.livescience.com/33731-anesthesia-work.html https://www.livescience.com/33731-anesthesia-work.html

333 points by smoyer 6y ago

That this happened from a local anesthetic is very, very strange. Before reading the story I wondered what combo of drugs they'd used to knock him out, because those can be risky. While I don't see any direct relation, this article makes me recall another discussing gum disease prevalence in Alzheimer patients.

kozak 6y ago
Toxic effect of an accidental intravascular injection? Who knows where that vessel went...
elric 6y ago
I have a friend who suffered permanent nerve damage from a simple local dental anaesthetic. Given a large enough sample size, I guess unlikely things will crop up?
- rscho 6y ago
  Peripheral nerve, yes. But not brain damage I guess? Yes, that's a possible and well-known complication, although quite rare.

SketchySeaBeast 6y ago

Hopefully something can be learned from his experience, but what a tragedy. It seems like a waking nightmare.

chrisacky 6y ago

Christopher Nolan did the screenplay for Momento which was one of my favourite films a few decades back about a guy who has anterograde amnesia[1]. [1] : https://en.wikipedia.org/wiki/Anterograde_amnesia https://en.wikipedia.org/wiki/Anterograde_amnesia

user_ 6y ago
Christopher Nolan based the screenplay for Memento (which he directed, as well) on a short story[1], Memento Mori, written by his brother Jonathan. [1] https://www.londonscreenwritersfestival.com/assets/Memento-Short-Story-by-Jonathan-Nolan.pdf https://www.londonscreenwritersfestival.com/assets/Memento-S...

jkinudsjknds 6y ago

The gums are full of nervous tissue. It's a straight line to the brain.

im3w1l 6y ago

What a fascinating case - that he is even unable to learn procedural skills. Speculating wildly here, but with learning being at the very core of what neurons do, the issue seems "low level" enough that it might even show up if you put a tissue sample in a petri dish.

codetrotter 6y ago

> he wakes up every morning believing he is still in Germany in 2005, waiting to visit the dentist That’s some real-life eternal Groundhog Day stuff right there. Hellish :( > Today, he only knows that there is a problem because he and his wife have written detailed notes on his smartphone, in a file labelled “First thing – read this”. This is more positive, and reminds me of the movie 50 First Dates with Adam Sandler. Also, am glad to hear he has someone in his life that is by his side.

the_af 6y ago
It could also remind you of Memento, though that brings you back to "hellish" ;)
- bmlzootown 6y ago
  50 First Dates... Much more fitting comparison, at least in terms of waking up to the "same" day over and over (as she too had some sort of amnesia).
  - the_af 6y ago
    To be fair, I haven't watched 50 First Dates so you might be right! In Memento, Leonard also wakes up each day to the "same" day because he (arguably) has anterograde amnesia and cannot form new memories. He keeps tracks of new developments he wants to remember by writing on his own body and on the backs of polaroids (a bit like writing a note with his smartphone! Memento was filmed in 2000, and smartphones didn't exist yet).
    - paranoidrobot 6y ago
      50 First dates is the more romantic story about a guy who meets a girl who has ~~ante-rograde amnesia~~. e: I forgot, in the movie she has a fictitious disease that's sort of like ante-retrograde amnesia, but wipes her memory when she sleeps.
    - wernercd 6y ago

ddlatham 6y ago

What would it take for you to be convinced after you wake up this morning that you had this condition and the year was actually 2035 right now? Rot13 after you've thought of an answer: Abj nfx lbhefrys, ubj uneq jbhyq vg ernyyl or sbe gung gb or snxrq?

aaomidi 6y ago
My phone's clock and going to Google.com and being able to load it. Assuming it's still around. If not I doubt it'll fail with a cert error.
- briefcomment 6y ago
  Imagine waking up and seeing an iPhone for the very first time. In 2005, the latest phone he probably had was some flip phone.
  - SketchySeaBeast 6y ago
    "Ah sweet, what else do we have? Are all cars electric? Did we make a manned flight to Mars? Have we cured cancer?" "Oh, that's about it. We have iPhones now. And to be honest, they are kind of a problem."
  - ilkkao 6y ago
    The article should have explained this in little more detail. Does he have a 2005 phone, probably Nokia Symbian? Or does he actually remember something and can use android or iphone. In the first case, a written note in his own handwriting would make more sense I guess.
  - cgriswald 6y ago
    ...and then going outside and seeing an orange sky and all the people wearing masks.
  - mikestew 6y ago
    Imagine you were me in 2005 with an HTC 8125 that had a sliding keyboard with actual QWERTY keys, and I wake up to find that all “smart” phones are black slabs of glass that I’m suppose to poke at with my paws like some kind of animal. I’ve since come to terms with the glass keyboard of my iPhone, but I maintain that it was not progress. Besides, the person in the story was only two years out from seeing an iPhone for the first time, like everyone else at the time.

nindalf 6y ago

@dang could we get rid of the clickbait title? Something more like "Man suffers anterograde amnesia after routine dental surgery"

smoyer 6y ago
> clickbait I considered changing the title when I submitted this but went with the HN guidelines that prefer the publisher's title. Admittedly the article's header might be a bit better than the slug in this case (but I was lazy).
st_goliath 6y ago
> Something more like "Man suffers anterograde amnesia after routine dental surgery" "... he'll never know what happened next"
haffi112 6y ago
It's not clear that there is any causal relationship between the dentist appointment and the resulting events. Possibly this event was bound to happen and it just so happened that the subject was visiting a dentist. At least I hope people won't get even more scared of dentists after reading this... but I guess BBC succeeded in that.

Freak_NL 6y ago

<SCARY DENTIST PHOTO; FULL-WIDTH> Somewhat interesting story <RANDOM PSEUDO-RELATED STOCK PHOTO> More of the story <RANDOM PSEUDO-RELATED STOCK PHOTO> Some more story <RANDOM PSEUDO-RELATED STOCK PHOTO> Some more story <RANDOM PSEUDO-RELATED STOCK PHOTO> (Scroll down to far) <COMPLETELY DIFFERENT STORY STARTS> If this is the future of the BBC (being in the 'future' category of the website), then I'll pass on that.

MattGaiser 6y ago
The thing is that everyone does this and everyone is paying to do this (as stock photos are not free). I assume it is passing A/B testing.
- agustif 6y ago
  If you're cheap there's unsplash though, nice quality for the pricetag (free)
- vorpalhex 6y ago
  There's a time and place for this technique. I do it on my posts where I'm showing you something as it evolves - usually an electronics project. Long running narratives are usually not the place for this.
- Doctor_Fegg 6y ago
  Apparently the BBC has a bulk deal with stock photo agencies where they basically get unlimited usage for £££ every year. I found this out when I asked them why they were using a Getty image of Broadcasting House (in a story about BBC office moves) rather than just stepping out into the corridor and taking one...
sandworm101 6y ago
Look deeper at the first photo. That isn't even a real dentist. Those are not medical/laser safety glasses. They look like they came out of a carpenter's toolbox. And look at the tool in his right hand (camera left). We have all been eye-to-hook with the various dental implements. That doesn't look like any tool i've ever seen. I think it is a prop, a blunt tool so that actors don't cut themselves. If the BBC is going to use a stock image, at least use the one of a real dentist. (I can forgive the faked scratches on the glasses. That was probably done so we don't see the reflected image of the camera lens.)

not_a_moth 6y ago

I remember Roger Penrose talking about the mystery of anesthetics, how they may target the vast "microtubule" network in the brain, itself a pretty surprising and unknown structure. So little we know I suppose.

DonaldFisk 6y ago
In this case, his dentist used local anaesthetic. Penrose was referring to general anaesthetics and their effect on consciousness.
KingFelix 6y ago
He spoke last week about it at The Towards a Science of Consciousness conference (Univeristy of Arizona) Stuart Hammeroff and Penrose have the Orc OR Theory of Consciousness. Stuarts an anesthesiologist

aazaa 6y ago

> Since then, he has been unable to remember almost anything for longer than 90 minutes. So while he can still tell me about the first time he met the Duke of York for a briefing at the Ministry of Defence, he can’t even remember where he’s living now; he wakes up every morning believing he is still in Germany in 2005, waiting to visit the dentist. Without a record of new experiences, the passing of time means nothing to him. Today, he only knows that there is a problem because he and his wife have written detailed notes on his smartphone, in a file labelled “First thing – read this”. This almost perfectly captures the premise of the movie Memento.

patorjk 6y ago

> Given the evidence, Burgess instead suspects the answer may be hiding in the thicket of tiny neural connections we call “synapses”. Once we have experienced an event, the memories are slowly cemented in the long term by altering these richly woven networks. That process of “consolidation” involves the production of new proteins to rebuild the synapses in their new shape; without it, the memory remains fragile and is easily eroded with time. I was reading the other day about a study that's checking to see if injecting BDNF [1] into a patient's cochlea will help improve their hearing. In animal studies it helped rebuild broken synapses and led to better hearing. I wonder if injecting the brain with the missing proteins (or as the article refers to them, "ink") would help with the formation of memories? Though maybe this is too simplistic of a view. [1] https://en.wikipedia.org/wiki/Brain-derived_neurotrophic_factor https://en.wikipedia.org/wiki/Brain-derived_neurotrophic_fac...

jonawesomegreen 6y ago

> Since then, he has been unable to remember almost anything for longer than 90 minutes. ... Without a record of new experiences, the passing of time means nothing to him. Today, he only knows that there is a problem because he and his wife have written detailed notes on his smartphone, in a file labelled “First thing – read this”. I think it would be fascinating to read the "First thing - read this" file on his phone. I can see why they don't go into more detail it would probably be pretty personal info in there. Still as a mental exercise, its interesting to think about what I would write down in that file for myself.

andai 6y ago

I heard that the upper teeth are close to the brain and tooth infections can cross the blood-brain barrier so that was my first thought, but it doesn't seem to be the case here (the transition was instant, the damage doesn't appear to be local or getting worse).

larrik 6y ago
This happened to my grandmother. One week she was sharp as a tack. Next week, lit her house on fire to clear a paper jam... Doctor's claimed dementia, turned out to be a tooth infection.
rscho 6y ago
teeth abcesses can degrade really fast (like, minutes). root canal infectious migration to the brain is actually the most likely cause here, in my opinion.

iso1210 6y ago

That entire page and no mention of the Adam Sandler/Drew Barrymore film 50 First Dates, which came out a year before and covers a woman who wakes up every morning thinking it's the same day? At the time of release it seemed to be a medical condition that wasn't real, however there have been a couple of instances diagnosed since then.

jawns 6y ago

To me, the most disturbing part of this story came at the very end, where it says that he has just relearned, for the thousandth time, that his children are now in their late teens and early 20s -- whereas his last memory of them was as little kids. If that were me, and I were just informed that my own little children had essentially disappeared, I would likely go catatonic. I mean, in a sense, even though they're still present as young adults, it's as if your children have died. I don't know how a person could cope with being told that even once, much less a thousand times.

DoofusOfDeath 6y ago
FWIW, I metaphorically went though that myself, by being overly focused on grad school and professional development while they were young. I would give almost anything to undo that mistake. If you don't mind a suggestion, take lots of video and get lots of audio recording of them. Their little-kid voices don't last forever. And once they're past the obnoxious teenage years, you may find you can't even remember their earlier voices. (AFK to dry my eyes and go give my kids a hug.)
- bentcorner 6y ago
  > If you don't mind a suggestion, take lots of video and get lots of audio recording of them. Totally agree. The firsts are a source of joy and the lasts make me melancholy.
- Aeolun 6y ago
  This is probably the best part about ubiquitous smartphones. Making a video is almost always possible. At the same time, I don’t think we should ignore the experience in the moment just to take a video for later.
fatnoah 6y ago
That is the part that got to me as well. To see your children, but effectively not know the people they've become as they've grown must be devastating.
mcphage 6y ago

ChrisArchitect 6y ago

(2015)?! cmon https://news.ycombinator.com/item?id=9833717 https://news.ycombinator.com/item?id=9833717

myself248 6y ago

My memory took an absolute nosedive, not quite this severe but I have tremendous trouble, after being knocked out for a colonoscopy. I've lived in "brain fog" ever since, and my memory is a shadow of what it once was. I've gotten extremely rigorous at writing notes for myself, doing sketches which I never used to need, and otherwise compensating. I hold it together on a professional note, but personal relationships have suffered badly. I guess I need to take better notes about them, which I don't currently do. As horrific as this story is, I guess it's good to know that I'm not alone?

doublesCs 6y ago
I never had long-term consequences, but one thing I learned from my one surgery, is that general anesthetics are absolutely brutal.
- nerdponx 6y ago
  You aren't (or shouldn't be) put under general anesthesia for a colonoscopy. They use "conscious sedation", in the USA typically achieved with intravenous propofol. You are technically conscious, but very sleepy and unable to form memories while sedated. But yes, general anesthesia is really wild stuff. Even more wild when you learn that we don't know how they actually work, other than that they work.
  - AuryGlenz 6y ago
    It also made me giggle right before my colonoscopy, so that’s nice if not embarrassing.
  - taylodl 6y ago
    They gave me a "sedative" for my colonoscopy. They just said it will make me really relaxed and maybe sleepy. I wasn't sleepy at all but boy was I relaxed! I remember laying on my left side, the doctor behind me controlling the scope, and the nurse in front of me but not obstructing the views of the monitors that were also in front of me. I was getting an awesome inside view of my guts! At one point I was feeling some pain and making some noises about it and the nurse told the doctor to hold on, apparently there was a pretty tight turn and she kneaded my guts so they could negotiate it. They did find a polyp and showed it to me on the monitor, TBH you have to have a trained eye to recognize those, so they biopsied it right then an there. The results came back a few days later saying it was benign. Unfortunately since they found a polyp they have me on a five year colonoscopy schedule instead of ten. For those fretting about getting a colonoscopy, like I was, let me tell you it's no big deal. I've had dental cleanings that were more uncomfortable. In fact, there was nothing about my colonoscopy that was uncomfortable. Getting your guts cleaned out in preparation for the colonoscopy? Yeah that's a different story but the actual procedure itself is a big nothing burger.

gattilorenz 6y ago

For another incredible case of retrogade amnesia, check the story of Clive Wearing, the men with a few seconds of memory. Short clip: https://www.youtube.com/watch?v=Vwigmktix2Y https://www.youtube.com/watch?v=Vwigmktix2Y Extended documentary: https://www.youtube.com/watch?v=k_P7Y0-wgos https://www.youtube.com/watch?v=k_P7Y0-wgos I learned of him through neuroscience classes. That was plenty of years ago, and I still think of his condition every now and then. One thing that amazes me is that he keeps stacks of diaries where he keeps erasing the previous entry, adding the current date and time, and writing "first entry I made consciously" (https://youtu.be/k_P7Y0-wgos?t=1113 https://youtu.be/k_P7Y0-wgos?t=1113). But also, it seems that over time he does learn something new, somehow. For example, he can now reliably "predict" the ending of movies he has seen a great amount of times after the amnesia started, without remembering of having ever seen the movie. And, of course, it's touching to see the relationship with the wife.

cblconfederate 6y ago

HM has been such a monumental case in neuroscience, that a case like this would mean a huge shift in the way people think about hippocampus and memory. We already know that his amnesia it was more severe due to parahippocampal areas being removed rather than just hippocampi. Still, he was only one case, upon which thousands and thousands of studies have rested on.

blackbear_ 6y ago

I had a similar experience, when a friend got hit by a car and hit his head when falling. After all due checks were performed at the hospital and I was allowed to see him, his memory would reset every five minutes. He would stare blankly at the wall for a few seconds, then ask the same questions all over again: where am I, what day is it, and so on. After a while we just gave him a piece of paper with a brief explanation of what happened and some FAQs. I must confess, I had some (innocent) fun. Now he's fine, as if nothing happened, and we laugh every time we remember this.

gizmondo 6y ago
Happened to me during a soccer game, was gone next morning. I think it's not so rare symptom of concussion, i.e. quite different than what the article describes.

NiceWayToDoIT 6y ago

Recently I watched movie "Brain on Fire" sorry a big spoiler ahead, in it main protagonist a girl had auto-immune disease so one half of brain got inflamed. She was showing symptoms like she had schizophrenia. After fixing auto immune problems and brain inflammation everything return to normal with some after effects. That being said and knowing that root canals can get inflamed and that inflammation can spread trough nerves to brain how lightly is the cause of his amnesia has a similar cause? Neurologist among you what is the brain region that is most probably first to be affected if that would happen?

rscho 6y ago

Why does everyone assume it's due to anesthesia? It's not stated like that in the article, I think. And it's also very unlikely pharmacologically speaking. Could be infection. Could be a random stroke that happened at the just the right time...

newobj 6y ago

(pre-rant: Why do people post medical articles on HN? If you say anything in response to them, you get downvoted because you're not a scientist/doctor/yada yada.) Having said that: people w/ MTHFR mutations are cautioned against nitrous during general anesthesia: https://www.scielo.br/scielo.php?pid=S0034-70942019000600637&script=sci_arttext https://www.scielo.br/scielo.php?pid=S0034-70942019000600637... https://pubmed.ncbi.nlm.nih.gov/18008117/ https://pubmed.ncbi.nlm.nih.gov/18008117/ It's funny, most people, even doctors, don't yet seem to know anything about MTHFR, but my son's dentist knew this (he has heterozygous mutations on 677 and 1298; I am homozygous 677) - so when I brought up MTHFR, she knew what to do - give him kiddie xanax rather than nitrous. I thought I was going to have to fight her about it, but nope. (also: i know this article is about local anesthesia, i'm making a more general comment about anesthetics and complications)

hackinthebochs 6y ago
How did you find out about the MTHFR mutation? Does it present with some visible symptoms such that a diagnosis will likely be made?
- bionhoward 6y ago
  Try a consumer genomics company like 23andme or nebula
PragmaticPulp 6y ago
Anything MTHFR-related has become a minefield of bad science on the internet. The amount of misinformation around the MTHFR gene is staggering, not to mention the droves of websites trying to sell various supplements and ebooks to people who are concerned about their MTHFR gene mutations. > Having said that: people w/ MTHFR mutations are cautioned against nitrous during general anesthesia: That's not exactly what those studies are saying. The latter is a single case report of an isolated incident which the authors hypothesized to be related to her rare homozygous MTHFR mutation. The former paper cites the latter paper as one of only two references. Needless to say, the evidence is quite weak. Moreover, the first paper recommends alternative methods that have their own downsides. It's remarkable that people are so quick to assume entire professions have overlooked something so obvious as the MTHFR mutation based on a pair of linked papers. In fact, the latter paper even goes so far as to say they are not advocating for removal of nitrous oxide nor for preemptive screening for the MTHFR mutation.

sliken 6y ago

I ended up on a several hour car ride with an anesthesiologist, he mentioned that Dentists are often grandfathered in, and often end up doing serious procedures without an anesthesiologist involved. So while they are focusing on the procedure heart rate, breathing rate, O2, etc aren't monitored nearly enough. Apparently getting panicked calls from dentists was not unusual. In one particular case a 18 year old woman wouldn't wake up, he helped as much as he could, but she was never the same. Morale of the story, don't let a dentist put you under without an actual anesthesiologist involved.

tachyonbeam 6y ago
So I guess what might be going on here, is partial brain tissue death from lack of oxygen, or something like that? Holy fuck.
- winrid 6y ago
  Yeah, after reading this I'll never go under without an anesthesiologist.
rscho 6y ago
Well, I'd say monitoring is the minor issue in such cases. The real issue is that when something happens, and something will happen someday over the duration of a career, anesthesiologists are basically the only ones who can really help. Unfortunately, you have to pay for anesthesia and they will want to do things their way so that's very annoying for other specialists.
disown 6y ago
> Morale of the story, don't let a dentist put you under without an actual anesthesiologist involved. An anesthesiologist says anesthesiologists are indispensable? How shocking. There are plenty of horror stories when anesthesiologists are involved as well. The moral of the story is whenever possible, try and not to be put under.
- sliken 6y ago

WhiteWestie 6y ago

My cousin lost her sense of taste after a routine dental surgery, removing her wisdom teeth. My sister also lost hers while removing her wisdom teeth (different dentist) but recovered after a few weeks taking some vitamins prescribed by the dentist.

cableshaft 6y ago
The front of my tongue no longer tastes, and barely feels anything, after dental surgery (probably local anesthetic from a root canal). I can still taste in the back of my tongue, thankfully, but my sense of taste overall has definitely diminished. I feel sorry for your cousin. I had gotten the local anesthetic several times without issue, it was just that one time that I got unlucky. Supposedly if the sense of taste doesn't come back after two years it's not likely to, so I guess this is my life now.

sradman 6y ago

The paper Profound anterograde amnesia following routine anesthetic and dental procedure [1] > Anterograde amnesia caused by bilateral hippocampal or diencephalon damage manifests in characteristic symptoms of preserved intellect and implicit learning, and short span of awareness with complete and rapid forgetting of episodic material. A new case, WO, 38-year-old male with anterograde amnesia, in the absence of structural brain changes or psychological explanation... amnesia onset coincided with anesthetic injection and root canal procedure, with extended vasovagal-like incident. > WO attended a routine dental appointment for root canal treatment at 13:40 hours. He was injected with the anesthetic, Citanest with Octapressin 3% just prior to the beginning of treatment. He wore tinted dental glasses, obscuring a view to his level of responsiveness. The procedure was completed at 14:30 hours, and at this time it became apparent that WO was pale and faint, and could not get himself up when re-positioned from the supine to the upright position. So after the 50 minute dental surgery, the patient was still suffering from something similar to an extended fainting spell (vasovagal syncope). This resulted in permanent brain dysfunction isolated to the parts of the brain associated with forming long-term memory without any measurable structural damage. A weird but fascinating puzzle. Question 1: does oxygen deprivation in the brain result in measurable structural damage? Question 2: can an anaesthetic selectively impact one artery servicing the brain? [1] https://pubmed.ncbi.nlm.nih.gov/25978125/ https://pubmed.ncbi.nlm.nih.gov/25978125/

novia 6y ago

Something I want to know, that no article seems to mention is, which tooth? If theoretically there is a memory mechanism external to the brain, wouldn't this offer a hint to where to look for one?

csomar 6y ago
My guess is this is probably caused by the anesthetic. Maybe it somehow got its way to his brain and damaged his hippocampus. That they didn't find any brain damage, doesn't mean he didn't get any brain damage. https://c8.alamy.com/comp/2AA7CBF/an-anatomical-cross-section-of-a-head-showing-teeth-arteries-and-veins-coloured-engraving-by-a-tardieujpg-2aa7cbf-2AA7CBF.jpg https://c8.alamy.com/comp/2AA7CBF/an-anatomical-cross-sectio...
- rscho 6y ago
  My guess as an experienced anesthesiologist is that the most likely cause is infection. Anesthesia is far behind in terms of probability, although not 100% excluded. Even a random stroke would probably be more likely.

deleted 6y ago

[deleted]

chrischen 6y ago

I’m curious since this happened in Europe, is that dentist liable for malpractice? Who has to pay for his subsequent medical bills / loss of employment?

sohkamyung 6y ago

John Varley wrote a story about this kind of medical condition: "Just Another Perfect Day" [1]. [1] https://www.lightspeedmagazine.com/fiction/just-another-perfect-day/ https://www.lightspeedmagazine.com/fiction/just-another-perf...

mickelsen 6y ago

A year ago, after getting a nasal cautery (third one in a year in a nostril that kept being problematic) I started getting spasms between my neck and shoulder, it happens whenever I'm laying on the bed on that side. Massage makes it worse, but that's also my "bad side" when it comes to muscle knots, even before the little surgery. Stopped wearing a backpack since then to see if that was the culprit, cut down on caffeine, MRI & Angio show up OK, but still no go. Maybe the ENT messed up my nerves? Asking for a friend.

ilkan 6y ago

"Despite their necessity in modern medicine, scientists aren't sure exactly how anesthetics work. The best theory suggests that they dissolve some of the fat present in brain cells, changing the cells’ activity. But, the precise mechanisms remain unknown." Perhaps it works by stopping the protein synthesis... Permanently in his case https://www.livescience.com/33731-anesthesia-work.html https://www.livescience.com/33731-anesthesia-work.html