Korsakoff’s disease (Korsakov’s disease) is a brain disease characterized by severe memory disorders. Occurring memory lapses usually fill those affected with invented contents (confabulations). The disease usually occurs in people who have consumed too much alcohol for years. The disorders are usually not completely reversible even with proper therapy. Read more about Korsakoff syndrome here – symptoms, diagnosis and treatment.
Korsakoff syndrome: description
The Korsakov syndrome is a brain disorder that greatly reduces the memory performance: sufferers are usually confused and disoriented to outsiders and fill occurring memory lapses with fictitious facts (confabulations).
In most cases, Korsakoff syndrome is the result of many years of alcohol abuse. In this context, Korsakoff syndrome is usually preceded by brain inflammation (Wernicke’s encephalopathy), which is also caused by excessive alcohol consumption. Since the symptoms of both diseases are sometimes very close together and a Wernicke’s encephalopathy is often followed by a Korsakoff syndrome, doctors also classify both diseases as Wernicke-Korsakoff syndrome.
However, Korsakoff syndrome can also be caused by causes other than alcohol abuse, such as severe head injury or brain inflammation (encephalitis).
Consistent treatment can improve symptoms in some people with Korsakoff syndrome. A thorough success is only possible in a small part of the patients. A very long-standing Korsakoff syndrome with severe deficits is unlikely to be treated.
Korsakoff syndrome: symptoms
Patients with Korsakoff syndrome have clear signs of a so-called amnestic syndrome. The term “amnestic syndrome” summarizes various disorders and changes in the brain that primarily affect memory.
Therefore, people with Korsakoff syndrome often make a very confused and disoriented impression on their fellow human beings. For example, they are not or hardly able to remember new information. Just what has been said or discussed with each other can be “gone” a moment later. Often people with a Korsakoff syndrome forget things that are further back: they may not know where they are (for example, in the hospital), what they want or want in their room (doctor) – even if they are have been in the hospital for several days / weeks and the doctor treats her several times a day. Likewise, they may not remember the time or just before the onset of Korsakoff syndrome or hospitalization.
In part, the so-called old memory is also affected by Korsakov’s disease. This is how physicians describe memory, in which further events are stored. In this case, those affected can sometimes no longer remember biographically significant things, such as the death of a loved one or a separation.
Characteristic of people with a Korsakoff syndrome is their strong tendency to fill gaps in their memories with fictitious contents (confabulations). For example, patients respond to the demand for what they did the day before that they were shopping in the city – even if they have been in the hospital for weeks at a time. The doctor suddenly becomes a tax adviser (and the hospital to the tax office) because the patient no longer recognizes him as a doctor and replenishes the gap. This process is not aware of the person concerned and accordingly does not happen intentionally; it is not intentional lying or deception.
In addition to these symptoms, Korsakoff syndrome can also affect the personality of affected people. Thus, sufferers may appear inappropriately euphoric or distant, but also very depressed and passive.
Korsakoff syndrome: causes and risk factors
Korsakov syndrome with vitamin B1 deficiency
As a rule, especially those people fall ill with a Korsakoff syndrome, which have long had alcohol problems. In the process, a certain form of encephalitis first develops, a so-called Wernicke’s encephalopathy, which then causes a Korsakoff syndrome. Physicians also speak in this context of a Wernicke-Korsakoff syndrome. The cause of Wernicke’s encephalopathy is a severe deficiency of vitamin B1 (thiamine), which gradually damages the brain. Physicians assume that those affected then develop the Korsakoff syndrome, if certain hereditary conditions are met.
A vitamin B1 deficiency occurs in people seriously ill because they often take no or almost no food in addition to alcoholic beverages. Rarely, a thiamine deficiency also occurs in people with low alcoholism. There are also other diseases that can lead to a vitamin B1 deficiency: These include severe eating disorders, malignant changes in the gastrointestinal tract and kidney disease. People who are fed on infusions in the hospital also run the risk of getting severe vitamin B1 deficiency in certain circumstances. This is particularly the case when the level of thiamine is already greatly reduced before the start of infusions by alcohol abuse, eating disorders or other diseases.
Other causes of Korsakoff syndrome
Korsakoff syndrome (Korsakov’s disease) can also occur without previous vitamin B deficiency. For example, severe head injuries, strokes, malignant changes and / or head surgery, as well as virus-induced inflammation of the brain, can also lead to Korsakoff syndrome.
Korsakoff syndrome: examinations and diagnosis
Frequently, the doctor already has a conversation with patients and possibly relatives / caregivers to get a suspicion of Korsakoff syndrome. Especially with known alcohol dependence and a previous Wernicke encephalopathy, it is likely that a Korsakoff syndrome is present. But previous head injuries and surgeries, as well as other types of brain inflammation in the medical history can also guide the doctor to the diagnosis of Korsakov’s disease.
Alcoholic people should be given vitamin B1 before the definitive diagnosis to treat any Wernicke encephalopathy. Since Korsakoff syndrome often results from Wernicke’s encephalopathy, and both diseases may overlap, the steps to diagnose Wernicke’s encephalopathy may also be useful. These include a comprehensive blood test, a brainwave current measurement (EEG) as well as an examination of the spinal fluid (CSF diagnostics).
To exclude other diseases such as malignant growth in the head, strokes, viral infections of the brain and brain damage of other causes, the physician evaluates images of the cranial area (computed tomography, CT and / or magnetic resonance imaging, MRI).
Korsakoff syndrome: treatment
If Korsakoff syndrome has been caused by Wernicke’s encephalopathy (Wernicke-Korsakoff syndrome), the administration of vitamin B1 may help in partially alleviating the symptoms. In addition, Wernicke-Korsakov syndrome underlying diseases such as alcoholism or eating disorders should be treated.
Otherwise, the further treatment depends on the individual problems of the patient. For example, psychotherapeutic or psychiatric treatment can be helpful. The aim here is always to enable the patient to master his daily routine as well as possible despite illness-related deficits.
Korsakov Syndrome: Prevention
There are many different causes for a Korsakoff syndrome, and not all of them can be prevented. However, people with alcohol problems or eating disorders can significantly reduce their chances of contracting Korsakoff’s disease by seeking medical treatment. As a result, they can significantly reduce the risk of Wernicke’s encephalopathy, which often occurs as a result of vitamin B1 deficiency in alcoholics and eating disorders. This will then also the Korsakoff Syndrome, a frequent long-term consequence of Wernicke’s encephalopathy prevented.
Korsakoff syndrome: disease course and prognosis
Korsakoff syndrome is a chronic disease that in most cases does not completely recur. After the administration of vitamin B1, the general condition improved significantly in about one in seven patients. Important for the prognosis is whether underlying diseases such as alcohol dependence or eating disorders can be permanently overcome.
Many people with one Korsakoff Syndrome are so severely impaired in their abilities that an independent life is no longer possible without help.