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Korsakoff's syndrome is a neuropsychiatric disease whose symptoms are similar to amnesia. It is caused by a deficiency of vitamin B1 or damage to the parts of the brain responsible for memory processes. Korsakoff's syndrome most often affects people who abuse alcohol, but it can also manifest itself in the course of eating disorders, gastrointestinal cancer and after a stroke.

Korsakoff syndromeis sometimes referred to asWernicki-Korsakoff syndromebecause it combines two types of symptoms: neurological, i.e. Wernicki's encephalopathy, and psychiatric, that is, the Korsakov amnesty team. The disease was first discovered by Russian psychiatrist Sergei Korsakov. In the years 1887-1891, a series of his scientific articles was published in which he described the cases of several patients with severe memory deficits while maintaining consciousness. By looking for the causes of these symptoms, researchers found that they were related to chronic vitamin B1 deficiency, the lack of which causes irreversible changes in the brain.

Korsakoff's syndrome - causes

Post-mortem studies of people addicted to alcohol have shown that about 3 percent of alcoholics experience brain changes characteristic of Korsakoff's syndrome.

Korsakoff's syndrome may manifest itself in the course of diseases that cause disturbances in the absorption of vitamin B1 (thiamine) from the gastrointestinal tract. These include anorexia, bulimia, cancer of the stomach and intestines, and short bowel syndrome. But the most common cause of Korsakoff's syndrome is alcoholism. Alcohol damages the walls of the small intestine, where the most vitamin B1 is absorbed. Long-term thiamine deficiency leads to permanent changes in those parts of the brain responsible for memory and fact association.

Neurological injuries characteristic of Korsakoff's syndrome occur less frequently as a result of stroke, brain tumors or mechanical injuries of the skull.

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The daily requirement for vitamin B1 in an adult is approx. 1.5 mg. You can find her, among others in meat (especially pork), nuts (peanuts, pistachios), semolina, wheat bread.

People on a standard diet including meat and grains are not at risk of vitamin B1 deficiency.

Korsakoff's syndrome - symptoms

The symptoms of Korsakoff's syndrome can be divided into two types: neurological and psychiatric. The former include:

  • awkward gait,
  • sensory and movement control disorders,
  • nystagmus,
  • pupil inequality,
  • no reaction to light,
  • convulsions,
  • damage to peripheral nerves, skin changes and reddening of the mucous membranes (rarely).

The second group of symptoms concerns the psyche - they include:

  • current memory disorders - the patient cannot remember and recall new information;
  • difficulties with recalling past events - even if the patient remembers events from the past, it is usually difficult for him to establish their chronology, in his messages they are devoid of mutual relations, chaotic, disordered;
  • confabulations, or telling imaginary stories - are designed to fill in the gaps in memory;
  • disturbance of consciousness - the patient loses the sense of time, cannot indicate the order of dates, has a disturbed perception of space;
  • problems with abstract thinking.

It should be noted that a person with Korsakoff's syndrome remains conscious, reasoned logically and correctly carries out commands (except in cases where he has complete amnesia).

Korsakoff's syndrome - diagnosis

To diagnose Korsakoff's syndrome, a medical interview with the patient is usually enough. The patient does not have to reveal all the symptoms of the disease - sometimes Korsakoff's syndrome is diagnosed only on the basis of psychiatric symptoms, while neurological symptoms do not have to be present.

The final confirmation of the diagnosis is the determination of the level of vitamin B1 in the blood serum or in the urine - if it is significantly lowered, it indicates Korsakoff's syndrome. In case of diagnostic doubts, the diagnosis can also be made on the basis of the results of brain magnetic resonance imaging or computed tomography of the head. Tests should show that the symptoms of the disease are not due to a brain tumor, aneurysm, or a stroke.

Korsakoff's syndrome - treatment

Treatment of Korsakoff's syndrome consists in administering intravenous large doses of vitamin B1 in order to make up for its deficiency (in the amount of 50-100 mg per day). The effects of such treatment depend on the individual characteristics of the patient and the advancement of the disease. Mental changes caused by changes in the brain are difficult to heal completely - only in a quarter of patients the symptoms of Korsakoff's syndrome disappear completely, in half only partially, and in the remaining patients the treatment is not effective.

In order for the disease not to return, it is necessary to give up alcohol completely and to include a rich dietin B vitamins and low in carbohydrates.

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Category:

Psychiatry