Korsakoff’s Syndrome (Korsakoff’s Psychosis)

Definition
Korsakoff’s syndrome is a condition that mainly affects chronic alcoholics. It is also called Korsakov’s syndrome, Korsakoff’s psychosis or amnesic-confabulatory syndrome. It is a brain or neurological disorder caused by thiamine or Vitamin B1 deficiency. The syndrome is named after Sergie Korsakoff, a neuropsychiatrist who popularized the theory.
Causes
  1. Chronic Alcoholism. This syndrome is due to the direct effects of alcohol or to the severe nutritional deficiencies that are associated with chronic alcoholism. A lack of Vitamin B1 is common in people with alcoholism thus, Vitamin B deficiency is noted. In chronic alcoholism the condition usually occurs following delirium tremens.
  2. Malabsorption. It is also common in persons whose bodies do not absorb food properly (malabsorption).
  3. Other severe brain disturbances. The syndrome also occurs in other severe brain disturbances such as paralysis, dementia, brain damage, infections and poisonings.
  4. Dietary deficiencies
  5. Prolonged vomiting
  6. Eating disorders
  7. Effects of chemotherapy
  8. Hyperemesis gravidarum
  9. Severe malnutrition. Alcoholism may be an indicator of poor nutrition, which in addition to inflammation of the stomach lining causes thiamine deficiency.
Disease Process
A deficiency of thiamine or Vitamin B causes damage to the medial thalamus and to the mammillary bodies of the hypothalamus. As a result, generalized cerebral atrophy may occur. In cases where Wernicke’s encephalopathy, a neurological disorder that causes brain damage in lower parts of the brain called the thalamus and hypothalamus, accompanies Korsakoff’s syndrome the disorder is called Wernicke-Korsakoff syndrome.
In most cases, Korsakoff syndrome, or Korsakoff psychosis, tends to develop as Wernicke’s symptoms go away. It results from damage to areas of the brain involved with memory, thus, Korsakoff’s syndrome involves:
  • Neuronal loss or damage to neurons
  • Gliosis, which is a result of injury to the supporting cells of the central nervous system.
  • Hemorrhage or bleeding of the mammilary bodies.
Signs and Symptoms
  1. Anterograde amnesia or the inability to form new memories
  2. Retrograde amnesia or the loss of memory (can be severe)
  3. Confabulation or the reciting of imaginary experiences.
  4. Lack of insight
  5. Apathy or the absence of interest in or concern about emotional, social, or physical life
  6. Hallucinations or seeing and hearing things are not really present
  7. Delirium
  8. Anxiety
  9. Fear
  10. Depression
  11. Confusion
  12. Delusions and insomnia
  13. Painful extremities
Treatment
  1. Thiamine by injection into a vein or a muscle or by mouth. Usually, thiamine does not improve loss of memory and intellect that occur with Korsakoff’s psychosis. However it may improve symptoms such as delirium or confusion.
  2. Stopping alcohol use to prevent additional loss of brain function and damage to the nerves.
  3. Eating a well balanced and nourishing diet with increase intake of foods containing Vitamin B1.

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