Korsakoff's psychosis

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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}}}

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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.

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.

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.

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

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.

Alcohol psychology

Alcohol use

Alcohols Alcohol (grain) Alcoholic beverages Alcohol drinking attitudes Alcohol drinking patterns Legal drinking age Drinking behavior Drinking culture Social drinking

Alcohol abuse

Alcoholism Alcoholic hallucinosis Acute aclcohol intoxication Alcohol intoxication Alcoholic psychosis Alcohol withdrawal Binge drinking Blood alcohol concentration Chronic alcoholic intoxication Children of alcoholics Delirium tremens Driving under the influence Drunkenness Korsakoff's psychosis Underage drinking

Alcohol consumption and health

Alcohol and cancer Alcohol and weight Alcoholic liver disease Blackouts Effects of alcohol on the body Fetal alcohol syndrome Long-term effects of alcohol

Treatment of alcohol problems

Alcohol education Alcohol detoxification Alcohol rehabilitation Alcoholics anonymous Alateen Alcohol (abstinence) Assessment in alcohol psychology Codependency Drug usage screening Sinclair Method Sobriety

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. 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. Mercury poisoning can also cause it.

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.

See also

• Alcohol amnestic disorder
• Alcoholic Hallucinosis
• Alcoholic psychosis
• Confabulation
• Dementia

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

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