Little is known about the initial stages of information processing in amnesia as compared to normal memory. In this study, we used electrical spatiotemporal mapping to compare cortical activation during encoding and recognition in a 56-year-old patient with severe, chronic post-anoxic amnesia and an age-matched control group. Event-related potentials were recorded as the subjects performed a continuous recognition task composed of meaningful designs. Activation in the control group rapidly progressed through eight different electrocortical configurations over 700ms after onset of new stimuli. In contrast, activation in the amnesic patient was highly monotonous: it showed varying electrocortical patterns only during the first 150ms but then remained abnormally stable for the remainder of the analysed time window. Electrical source localisation revealed that the patient failed to activate distributed cortical networks and that his processing was confined to visual areas. The present study suggests that the rapid activation of distributed cortical networks is critical for efficient encoding. (Contains 6 figures and 2 tables.)