Korsakoff's psychosis

Korsakoff's syndrome ICD-10 F10.6 ICD-9 291.1, 294.0 OMIM {{{OMIM}}} DiseasesDB {{{DiseasesDB}}} MedlinePlus {{{MedlinePlus}}} eMedicine {{{eMedicineSubj}}}/{{{eMedicineTopic}}} MeSH {{{MeshNumber}}}

Korsakoff's syndrome (a.k.a. Korsakoff's psychosis, amnesic-confabulatory syndrome or polyneuritic psychosis),is a continuum of Wernicke's encephalopathy, though a recognised episode of Wernicke's is not always obvious. Individuals diagnosed with Korsakoff's syndrome usually have symptoms of severe anterograde and retrograde amnesia, as well as confabulation. The syndrome is named for Sergei Korsakoff, the neuropsychiatrist who popularized the theory.

These symptoms are caused by damage to mammillary bodies and other brain regions due to deficiency of thiamine (Vitamin B₁). This is most often caused by chronic alcoholism, though other conditions including severe malnutrition have been known to cause it. Alcoholism is often an indicator of poor nutrition habits, which in addition to inflammation of stomach lining, causes the thiamine deficiency. When Wernicke's encephalopathy accompanies Korsakoff's syndrome, the combined syndrome is called the Wernicke-Korsakoff syndrome.

Pathologically, there is neuronal loss, gliosis, and hemorrhage in mammillary bodies. Damage to the dorsomedial nucleus of the thalamus is also associated with this disorder.

Intravenous (IV) or intramuscular (IM) injection of thiamine is used to treat this condition, though recovery is slow and often incomplete.

A famous case study is recounted by Oliver Sacks in "The Lost Mariner", which can be found in The Man Who Mistook His Wife for a Hat.

Another case is that of the Australian artist Charles Blackman.

Causes

Korsakoff's syndrome is a degenerative brain disorder, which is caused by the lack of thiamine, or Vitamin B1, in the brain. This disorder may be a result of alcohol abuse, dietary deficiencies, prolonged vomiting, eating disorders, or the effects of chemotherapy. It can also occur in pregnant women who have a form of extreme morning sickness known as hyperemesis gravidarum. Mercury poisoning can also cause it.

Symptoms

• Ataxia
• Apathy
• Retrograde amnesia and anterograde amnesia
• Confabulation (inventing events to compensate for gaps in memory)
• Tremors
• Paralysis of muscles controlling the eye
• Lack of insight to the condition
• Coma

Treatment

The treatment of Korsakoff's syndrome involves replacing the thiamine and providing proper nutrition and hydration. However, the amnesia and brain damage caused by the disease does not respond to thiamine replacement therapy. In some cases, drug therapy is recommended to the patient. If treatment is successful, signs will show within 2 years.

See also

Alcohol amnestic disorder

Key texts

Papers

• Jaffe, P.G. and Katz, A.N. (1975) Attenuating anterograde amnesia in Korsakoff's psychosis, Journal of Abnormal Psychology 84: 559-62.

Additional material

Papers

• Google Scholar

External links

• Strangers is a play by Edward Einhorn based on the syndrome.
• The Merck Manual: Function And Dysfunction Of The Cerebral Lobes - Amnesias - Korsakoff's syndrome
• Simple description of Korsakoff's syndrome

de:Korsakow-Syndrom es:Síndrome de Korsakoff fr:Syndrome de Korsakoff nl:Syndroom van Korsakov

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