It's the dementia talking
Confabulation
Amanda Wiggins; Jessica L. Bunin.
Author Information and Affiliations
Last Update: August 28, 2023.
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Definition/Introduction
Confabulation is a neuropsychiatric disorder wherein a patient generates a false memory without the intention of deceit.
[1] The patient believes the statement to be truthful, hence the descriptive term “honest lying.”
[2] The hypothesis is that the patient generates information as a compensatory mechanism to fill holes in one’s memories.
[3] It functions for self-coherence, integration of memories, and self-relevance.
[4][1] Confabulations can include small details such as birthdays, or they may be fantastical and more broadly based.
[5] They can be believable or bizarre. Presenting patients with contradictory information may further perpetuate confabulation in an attempt to explain their account.
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Issues of Concern
Associated Conditions
The most common reports of confabulation are in patients with Korsakoff syndrome from Wernicke encephalopathy, wherein patients have anterograde amnesia in addition to confabulations.
[6] It has been seen in several other disease processes to include Alzheimer dementia, traumatic brain injury, schizophrenia, bipolar disorder, anterior communicating artery aneurysms, and cortical blindness with Anton syndrome. It can, however, also present in otherwise healthy patients.
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Mechanism
Multiple reported lesions have correlations with the phenomenon. While most disorders associated with confabulation are related to lesions in the orbitofrontal or ventromedial prefrontal cortex of the frontal lobe, errors in processing may also occur within the hypothalamus, mammillary bodies, and the dorsomedial nucleus of the thalamus.
[10][8][6][3][9] Due to the complex physiology, it is difficult to determine the exact mechanism of false memories. There are multiple theories regarding the evolution of and motivation behind confabulation, but there is no conclusive data.
[5]Memory tests may identify errors in executive function, temporal context confusion, or reduced memory capacity.
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