Korsakoff's syndrome

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at October 3, 2016
StartKorsakoff's syndrome

Korsakoff syndrome (also known as Korsakoff's syndrome and Korsakoff psychosis) is a severe memory disorder that is caused by the deficiency of vitamin B1 (beriberi), which is also known as thiamine. This condition is mostly caused by chronic alcoholism but other serious conditions may cause the same symptoms, which can make it hard to diagnose at first. For instance, those who suffer with chronic infections, AIDS, and poor nutrition may experience the debilitating symptoms of this syndrome; however, only medical testing can determine if an individual is suffering from the onset of this brain syndrome.

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Definition & Facts

Korsakoff syndrome is sometimes referred to synonymously as Wernicke-Korsakoff syndrome due to the frequency with which it's accompanied by Wernicke's encephalopathy. Individuals often first experience symptoms of Wernicke’s encephalopathy before they begin to suffer from the more devastating symptoms of memory loss associated with Korsakoff's syndrome.

By definition, encephalopathy is a medical term used to describe any syndrome that affects brain function or structure. When the brain becomes altered due to the thiamine deficiency, the endocrine system and central nervous system are affected, individuals will begin to experience symptoms that will diminish their memory and ability to function on a day-to-day basis.

Korsakoff syndrome was described by Russian physician, Sergie Korsakoff in the late 1800's when he observed symptoms of memory loss in chronic alcoholics.

Symptoms & Complaints

The main symptoms of Korsakoff psychosis are continual memory loss, confusion, and loss of mental activity that can often be confused with other brain syndromes such as Alzheimer’s syndrome. After an extended period of time, double vision (diplopia) and the inability to make new memories begins to set in.

The individual may suffer from long-term memory gaps that leave them vulnerable and feeling lost, which is a symptom that is similar to dementia. Korsakoff's syndrome can cause muscle weakness, loss of muscle coordination, uncomfortable leg tremors, and problems walking or difficulties with balance.

Another tell-tale symptom of this syndrome occurs when the individual begins to make up stories to make up for their loss of memory since they cannot recall facts and events due to their inhibited short and long term memory. This is called confabulation.

This syndrome is associated with bleeding and scarring in the brain and can even lead to coma or death over an elongated period of time if it has either gone untreated or if the individual is unresponsive to treatment and therapy.

Causes

Scientists are still studying this syndrome to understand the many variables that lead to brain damage and systemic deterioration. Medical professionals know that this syndrome is caused by a lack of thiamine, which is vital for producing enzymes and lipids needed to make neurons function properly.

It is known that chronic alcoholism lead to this devastating condition. Alcoholism harms the liver which then results in the liver's inability to store thiamine. Additional causes include malnutrition caused by anorexia nervosa and cancer. Gastric cancer and inflammatory bowel syndrome may also be causes of this syndrome. Bariatric surgery (that is, weight loss surgery), can also be a cause of Korsakoff's syndrome.

Thyrotoxicosis is another cause of Korsakoff's syndrome. Hyperemesis gravaridum and heart failure are additional causes of this condition.

Diagnosis & Tests

An individual that is diagnosed with Korsakoff syndrome may exhibit a wide range of symptoms or even exhibit the traditional signs of alcohol withdrawal at first.

The attending doctor will monitor the individual for a particular set of cognitive symptoms that identify the amount of memory loss has occurred in the individual.

Doctors can perform tests to identify this syndrome, such as observing eye abnormalities (such as nystagmus). Doctors will run blood tests such as measuring electrolytes, liver function testss, arterial blood gas tests, and a complete blood count.

They may perform tests and laboratory exams to find signs of malnutrition or perform a lumbar puncture (also known as a spinal tap) to get an accurate workup for an accurate diagnosis. Individuals are first diagnosed with Wernicke’s encephalopathy before symptoms show signs of Korsakoff syndrome, which usually is a secondary condition.

Treatment & Therapy

For individuals who have been diagnosed with this brain condition, intravenous or intramuscular thiamine will be administered for anywhere from three to seven days. This regimen may be followed up with oral dosage of thiamine on a regular schedule to help stabilize the endocrine and nervous systems. In severe cases, doctors may increase the dosage of thiamine.

The doctor may recommend supportive care if an individual does not respond to treatment. Institutionalization may be required for those who are unable to care for themselves.

Seeking psychological treatment for any underlying causal conditions such as alcoholism and anorexia will be necessary. This could include counseling, group therapy, psychotherapy (such as cognitive behavioral therapy) and psychiatric medications.

Prevention & Prophylaxis

Prevention of Korsakoff's syndrome involves preventing the underlying disorders that cause the syndrome. Seeking treatment for mental disorders like alcohol use disorder and eating disorders. Adopting a healthy diet can prevent a number of conditions.