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

Thiamine-2D-skeletal.png|

Korsakoff's psychosis

ICD-10	F106
ICD-9	291.1, 294.0
OMIM	[1]
DiseasesDB	14107
MedlinePlus	[2]
eMedicine	med/2405
MeSH	{{{MeshNumber}}}

Korsakoff's syndrome (Korsakoff's psychosis, amnesic-confabulatory syndrome), is a degenerative brain disorder caused by the lack of thiamine (vitamin B₁) in the brain. The syndrome is named after Sergei Korsakoff, the neuropsychiatrist who popularized the theory.

Contents 1 Symptoms 1.1 Indications 2 Treatment 3 Causes 4 Case studies 5 See also 6 References & Bibliography 7 Key texts 7.1 Books 7.2 Papers 8 Additional material 8.1 Books 8.2 Papers 9 External links

[edit] Symptoms

There are six major symptoms of Korsakoff's syndrome: anterograde and retrograde amnesia, or severe memory loss; confabulation, that is, invented memories which are then taken as true due to gaps in memory sometimes associated with blackouts; meager content in conversation; lack of insight, and apathy (the patients lose interest in things quickly and generally appear indifferent to change).

These symptoms are caused by a deficiency of thiamine (vitamin B₁), which is thought to cause damage to the medial thalamus and possibly to the mammillary bodies of the hypothalamus as well as generalized cerebral atrophy.^[1]

When Wernicke's encephalopathy accompanies Korsakoff's syndrome, the combination is called the Wernicke-Korsakoff syndrome. Korsakoff's is a continuum of Wernicke's encephalopathy, though a recognised episode of Wernicke's is not always obvious.

Korsakoff's involves neuronal loss, that is, damage to neurons; gliosis which is a result of damage to supporting cells of the central nervous system; and hemorrhage or bleeding in mammillary bodies. Damage to the dorsomedial nucleus of the thalamus is also associated with this disorder.

[edit] Indications

• 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

[edit] Treatment

Treatment involves replacing the thiamine by Intravenous (IV) or intramuscular (IM) injection, 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 two years though recovery is slow and often incomplete.

[edit] Causes

Conditions resulting in the vitamin deficiency and its effects include chronic alcoholism, and severe malnutrition. Alcoholism is often an indicator of poor nutrition, which in addition to inflammation of the stomach lining, causes thiamine deficiency.^[2] As well as alcohol abuse, causes include 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.^[3] Mercury poisoning can also cause it.

[edit] Case studies

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.^[4]

[edit] See also

• Alcohol amnestic disorder
• Alcoholic Hallucinosis
• Alcoholic psychosis

[edit] References & Bibliography

1. ↑ Kolb & Whishaw: Fundamentals of Human Neuropsychology, 2003, pages 473-473
2. ↑ http://www.alzheimers.org.uk/Facts_about_dementia/What_is_dementia/info_korsakoffs.htm
3. ↑ http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/korsakoffs_syndrome.jsp
4. ↑ http://www.theage.com.au/news/arts/artists-wonderland-is-back-in-town/2006/07/28/1153816384482.html

[edit] Key texts

[edit] Books

[edit] Papers

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

[edit] Additional material

[edit] Books

[edit] Papers

• Google Scholar

[edit] 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

v·d·e WHO ICD-10 mental and behavioural disorders (F · 290–319)
Neurological/symptomatic	Dementia (Alzheimer's disease, multi-infarct dementia, Pick's disease, Creutzfeldt-Jakob disease, Huntington's disease, Parkinson's disease, AIDS dementia complex, Frontotemporal dementia) · Delirium · Post-concussion syndrome
Psychoactive substance	alcohol (drunkenness, alcohol dependence, delirium tremens, Korsakoff's syndrome, alcohol abuse) · opiods (opioid dependency) · sedative/hypnotic (benzodiazepine withdrawal) · cocaine (cocaine dependence) · general (Intoxication, Drug abuse, Physical dependence, Withdrawal)
Psychotic disorder	Schizophrenia (disorganized schizophrenia) · Schizotypal personality disorder · Delusional disorder · Folie à deux · Schizoaffective disorder
Mood (affective)	Mania · Bipolar disorder · Clinical depression · Cyclothymia · Dysthymia
Neurotic, stress-related and somatoform	Anxiety disorder (Agoraphobia, Panic disorder, Panic attack, Generalized anxiety disorder, Social anxiety) · OCD · Acute stress reaction · PTSD · Adjustment disorder · Conversion disorder (Ganser syndrome) · Somatoform disorder (Somatization disorder, Body dysmorphic disorder, Hypochondriasis, Nosophobia, Da Costa's syndrome, Psychalgia)  · Neurasthenia
Physiological/physical behavioural	Eating disorder (anorexia nervosa, bulimia nervosa) · Sleep disorder (dyssomnia, insomnia, hypersomnia, parasomnia, night terror, nightmare) · </br>Sexual dysfunction (erectile dysfunction, premature ejaculation, vaginismus, dyspareunia, hypersexuality) · Postnatal depression
Adult personality and behaviour	Personality disorder · Passive-aggressive behavior · Kleptomania · Trichotillomania · Voyeurism · Factitious disorder · Munchausen syndrome · Ego-dystonic sexual orientation
Mental retardation	Mental retardation
Psychological development (developmental disorder)	Specific: speech and language (expressive language disorder, aphasia, expressive aphasia, receptive aphasia, Landau-Kleffner syndrome, lisp) · Scholastic skills (dyslexia, dysgraphia, Gerstmann syndrome) · Motor function (developmental dyspraxia) Pervasive: Autism · Rett syndrome · Asperger syndrome
Behavioural and emotional, childhood and adolescence onset	ADHD · Conduct disorder · Oppositional defiant disorder · Separation anxiety disorder · Selective mutism · Reactive attachment disorder · Tic disorder · Tourette syndrome · Speech (stuttering · cluttering)

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This page uses content from the English-language version of Wikipedia. The original article was at Korsakoff's syndrome. The list of authors can be seen in the page history. As with Psychology Wiki, the text of Wikipedia is available under the GNU Free Documentation License.