Objective: Memory deficits in children are rare. Less is known about the etiology, neuroanatomy, and natural history of pediatric amnesia. This case demonstrates amnesia in a child, changing status of the disorder, associated diagnostic difficulties and the challenges of counseling families. The lesion does not involve the left hippocampus, amygdala, or thalamus. Method: DB presented at 15 years of age with headaches and short stature. Imaging demonstrated a hypothalamic lesion that on biopsy was a low grade astrocytoma. He received 6 weeks of radiation. DB was treated for radiation necrosis. Tumor progression was noted on scan at 18 years old, associated with a change in memory. He was treated with chemotherapy. DB's most recent MRI, completed contemporaneously with his third assessment, demonstrated decreased tumor size; the family describes clinical deterioration. Results: DB has normal intellectual ability (most recent GAI = 82), denies depression, but has a memory disorder that has waxed and waned clinically but is identified on assessment. 5/2014 9/2014 3/2015 Standardized score Standardized score Standardized score CVLT - II Total T 12 17 7 SDFR −3.5 −3.5 −4.0 LDFR −4.5 −3.5 −4.5 REC Discrim −3.5 −4.0 −3.0 Heaton Memory measures Story memory learning -T 31 27 14 Story Loss % 23 48 17 Figure learning 20 45 41 Figure loss% 31 42 24. Conclusion: Amnesia is seen in children without evidence of left hippocampal or thalamic involvement. Clinical progression may be distinct from structural change. The impact of a memory disorder when progress and emancipation is anticipated is devastating. Depression is difficult to assess in the context of profound memory deficits.

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