Korsakoff

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Korsakoff's Syndrome
(Cerebral Beriberi, Korsakoff's Amnesic Syndrome, Wernicke-Korsakoff Syndrome)
Definition
Korsakoff's syndrome is a memory disorder caused by a lack of vitamin B1 (thiamin). 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
The Brain

Causes
In the United States, the most common cause of thiamin deficiency, and therefore Korsakoff's syndrome, is alcoholism. However this syndrome is also found in people with eating disorders, radical dieting, or who have had obesity surgery. People on dialysis, on long-term intravenous nutrition, and those with chronic disease are at an increased risk. The daily requirement of thiamin is 1-3 mg per day.
thiamin 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 deficiencies. In addition, alcohol increases the body's need for B vitamins while interfering with the ability to absorb, store, and use the nutrients.
Not all alcoholics get Korsakoff’s syndrome, which has lead to the thought that genetic abnormality may make some people more susceptible to this condition. The direct effects of alcohol on nerves in the brain may also contribute.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Risk factors include:
• 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 this condition 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, 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, individuals with Korsakoff's syndrome 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, including 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 this condition. 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 involves taking intravenous thiamin and drinking plenty of fluids right away. Because improvement is slow, you must supplement your diet with oral thiamin for many months. If alcoholism is the cause, you will also need treatment for that condition.
Prevention
To reduce your risk of developing Korsakoff's syndrome:
• Proper diet is key. Foods that are rich in thiamin include lentils, peas, fortified breakfast cereal, pecans, spinach, oranges, milk, and eggs.
• Talk to your physician about seeking help for alcoholism.