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Korsakoff's Syndrome

Definition:
Korsakoff's syndrome is a memory disorder caused by a lack of vitamin B1 (thiamine). It mainly affects short-term memory. A related disorder, Wernicke's syndrome, often occurs before Korsakoff's syndrome. Because they often occur together, the range of symptoms caused by the two diseases is often called Wernicke's-Korsakoff syndrome. The main symptoms of Wernicke's syndrome occur acutely. They include:
  • Difficulty with walking and balance
  • Confusion
  • Drowsiness
  • Paralysis of some of the eye muscles
Causes:
In the United States, the most common cause of thiamine deficiency, and therefore Korsakoff's syndrome, is alcoholism. This syndrome can also occur with forms of brain damage such as tumors, head injuries, and strokes.

Thiamine is necessary for memory and other brain functions. People who drink a lot of alcohol often replace food with alcohol. As a result, they take in fewer vitamins, leading to vitamin deficiencies. In addition, alcohol increases the body's need for B vitamins while interfering with its ability to absorb, store, and use thiamine.

A genetic abnormality may make some people more susceptible to Korsakoff's syndrome when they drink large amounts of alcohol and consume diets low in vitamins. The direct effects of alcohol on nerves in the brain may also contribute to Korsakoff's syndrome.

Risk Factors:
A risk factor is something that increases your chances of getting a disease or condition.
  • Alcoholism
  • Genetic susceptibility
  • Persistent vomiting leading to malnutrition
  • Medical or surgical conditions (such as obesity surgery) that may lead to poor food intake or absorption of nutrients
Symptoms:
The main symptom of Korsakoff's syndrome is severe memory problems. This is most notable with recent events and new information. Often, people with Korsakoff's syndrome do not know the date or day. However, long-term memory and overall intelligence usually remain intact. To fill in the gaps in recent memory, these patients tend to make up information that fits with the situation. This is called "confabulation."

Unlike people with other memory deficiencies, like Alzheimer's disease, Korsakoff patients seem unaware of their problem. Also, they do not typically get worried or concerned when it is pointed out. They also tend to develop emotional changes. These include blandness and little or no response to events around them.

Diagnosis:
The doctor will ask about your symptoms and medical history, and assess your mental function. Testing your ability to learn new information most likely will show if you have Korsakoff's syndrome. If you are an alcoholic and/or have Wernicke's syndrome, Korsakoff's syndrome is seriously considered as the cause of your memory problem.

Treatment:
Treatment of Korsakoff's syndrome involves taking intravenous thiamine and drinking plenty of fluids right away. Because improvement is slow, you must supplement your diet with oral thiamine for many months. If alcoholism is the cause of Korsakoff's syndrome, it needs to be treated.

Prevention:
To reduce your risk of developing Korsakoff's syndrome:
  • Eat a diet with sufficient thiamine. Thiamine is found in pork, peanuts, and wheat germ, among other foods.
  • If you are an alcoholic, get treatment for your addiction.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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