Korsakoff syndrome is a chronic memory disorder caused by severe deficiency
of thiamine (vitamin B-1). Thiamine helps brain cells produce energy from
sugar. When levels fall too low, brain cells cannot generate enough energy to
function properly. Korsakoff syndrome is most commonly caused by alcohol
misuse, but can also be associated with AIDS, cancers that have spread
throughout the body, chronic infections, poor nutrition and certain other
conditions. It is also common in people whose bodies do not absorb food
properly (malabsorption). This can sometimes occur with a chronic illness or
after weight-loss (bariatric) surgery.
Symptoms
Korsakoff syndrome causes problems learning new information, inability to
remember recent events and long-term memory gaps. Memory difficulties may be
strikingly severe while other thinking and social skills are relatively unaffected.
For example, individuals may seem able to carry on a coherent conversation but
moments later are unable to recall that the conversation took place or with
whom they spoke.
Those with Korsakoff syndrome may “confabulate,” or make up, information
they can’t remember. They are not “lying” but may actually believe their
invented explanations. Scientists don’t yet understand the mechanism by which
Korsakoff syndrome may cause confabulation. The person may also see or hear
things that are not there (hallucinations).
Diagnosis
Korsakoff syndrome is a clinical diagnosis representing a physician’s best
judgment about the cause of a person’s symptoms. There are no specific
laboratory tests or neuroimaging procedures to confirm that a person has this
disorder. The syndrome may sometimes be hard to identify because it may be
masked by symptoms of other conditions common among those who misuse alcohol,
including intoxication or withdrawal, infection, or head injury.
Experts recommend that a medical workup for memory loss or other cognitive
changes always include questions about an individual’s alcohol use. Anyone
admitted to the hospital for an alcohol-related condition should be
professionally screened for memory loss and cognitive change. The screening
should include supplementary questions to assess recent memory. If screening
suggests impairment, the person should receive a more detailed cognitive
workup.
Treatment
Some experts recommend that heavy drinkers and others at risk of thiamine
deficiency take oral supplements of thiamine and other vitamins under their
doctor’s supervision.
Many experts also recommend that anyone with a history of heavy alcohol use who experiences symptoms associated with Wernicke encephalopathy, including acute confusion, prolonged nausea and vomiting, unusual fatigue or weakness, or low body temperature or blood pressure, be given injectable thiamine until the clinical picture grows clearer.
Once acute symptoms improve, individuals should be carefully evaluated to determine if their medical history, alcohol use and pattern of memory problems may be consistent with Korsakoff syndrome. For those who develop Korsakoff syndrome, extended treatment with oral thiamine, other vitamins and magnesium may increase chances of symptom improvement. If there is no improvement, consideration should be given to treatment of comorbid deficiencies and medical conditions, and the need for long-term residential care or supportive accommodation.
Abstaining from alcohol and maintaining a healthy diet is a cornerstone of effective long-term treatment. Those with Korsakoff syndrome have a reduced tolerance for alcohol and may be at high risk for further alcohol-related health problems.
Many experts also recommend that anyone with a history of heavy alcohol use who experiences symptoms associated with Wernicke encephalopathy, including acute confusion, prolonged nausea and vomiting, unusual fatigue or weakness, or low body temperature or blood pressure, be given injectable thiamine until the clinical picture grows clearer.
Once acute symptoms improve, individuals should be carefully evaluated to determine if their medical history, alcohol use and pattern of memory problems may be consistent with Korsakoff syndrome. For those who develop Korsakoff syndrome, extended treatment with oral thiamine, other vitamins and magnesium may increase chances of symptom improvement. If there is no improvement, consideration should be given to treatment of comorbid deficiencies and medical conditions, and the need for long-term residential care or supportive accommodation.
Abstaining from alcohol and maintaining a healthy diet is a cornerstone of effective long-term treatment. Those with Korsakoff syndrome have a reduced tolerance for alcohol and may be at high risk for further alcohol-related health problems.
More info: https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/korsakoff-syndrome
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