Korsakoff syndrome

Question 1

What is Korsakoff syndrome?

Answer 1

A disorder of the central nervous system characterized by amnesia, deficits in explicit memory, and confabulation.

Caused by vit B1 deficiency (thiamine)

Question 2

What are the signs and symptoms of Korsakoff syndrome?

Answer 2

1. Anterograde amnesia
2. Retrograde amnesia
3. Confabulation
4. Minimal content in conversation
5. Lack of insight
6. Apathy

Question 3

What causes Korsakoff syndrome?

Answer 3

Thiamine deficiency as a result of excessive alcohol ingestion

Less commonly: severe malnutrition, anything that inflames stomach (vomiting), EDs, chemotherapy

Question 4

What is the pathogenesis of Korsakoff syndrome?

Answer 4

Thiamine is essential for the decarboxylation of pyruvate, and deficiency during this metabolic process is thought to cause damage to the medial thalamus and mammillary bodies of the posterior hypothalamus, as well as generalised cerebral atrophy.

These brain regions are all parts of the limbic system, which is heavily involved in emotion and memory.

Question 5

What are the risk factors for Korsakoff syndrome?

Answer 5

Age
Alcoholism
Chemotherapy
Dialysis
Extreme dieting
Genetic factors

Question 6

How would you diagnose Korsakoff syndrome?

Answer 6

History and clinical assessment

Question 7

What is the prognosis for Korsakoff syndrome?

Answer 7

Amnesia and brain damage don’t always respond to treatment. Brain damage caused by KS is only reversible in 20% of the cases

People diagnosed with KS are reported to have a normal life expectancy, presuming that they abstain from alcohol and follow a balanced diet

Question 8

How would you treat Korsakoff syndrome?

Answer 8

Treatment typically requires taking thiamine orally for 3 to 12 months

As an immediate form of treatment, a pairing of intravenous or intramuscular thiamine with a high concentration of B-complex vitamins can be administered three times daily for 2–3 days