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Korsakoff’s syndrome

Korsakoff’s syndrome is a manifestation of Wernicke’s encephalopathy, also known as Wernicke’s disease. Almost all alcohol abusers usually have Korsakoff’s syndrome. This neurological disorder is caused by a lack of Vitamin B in the brain, and is also often exacerbated by the neurotoxic effects of alcohol. 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 or disease, though a recognized episode of Wernicke’s is not always obvious. The syndrome is named after Sergei Korsakoff, a Russian neuropsychiatrist who discovered the syndrome during the late 19th century.

There are six major symptoms of Korsakoff’s syndrome:

anterograde amnesia
retrograde amnesia, severe memory loss
confabulation, that is, invented memories which are then taken by the patient as true due to gaps in memory, with such gaps sometimes associated with blackouts
minimal content in conversation
lack of insight
apathy — the patients lose interest in things quickly, and generally appear indifferent to change.

Treatment

Treatment involves the replacement or supplementation of thiamine by intravenous (IV) or intramuscular (IM) injection, together with proper nutrition and hydration. Treatment of the patient typically requires taking thiamine orally for 3 to 12 months. If treatment is successful, improvement will become apparent within two years, although recovery is slow and often incomplete.

As an immediate form of treatment, a pairing of IV or IM thiamine with a high concentration of B-complex vitamins can be administered three times daily for period of 2–3 days. In most cases, an effective response from patients will be observed. A dose of 1 gram of thiamine can also be administered to achieve a clinical response. In patients who are seriously malnourished, the sudden availability of glucose without proper bodily levels of thiamine to metabolize is thought to cause damage to cells. Thus, the administration of thiamine along with an intravenous form of glucose is often good practice.

Treatment for the memory aspect of Korsakoff’s syndrome can also include domain-specific learning, which when used for rehabilitation is called the method of vanishing cues. Such treatments aim to use patients’ intact memory processes as the basis for rehabilitation. Patients who used the method of vanishing cues in therapy were found to learn and retain information more easily.

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