By Korsakow syndrome, physicians mean a form of memory impairment (amnesia), which is one of the mental disorders. The patient has great difficulty remembering newly experienced or learned things. Often, Korsakow syndrome occurs as a result of many years of alcohol abuse.
What is Korsakow syndrome?
Korsakow syndrome, alternatively called Korsakow’s disease or amnesic psychosyndrome, is a mental disorder. More specifically, it is a form of amnesia (memory impairment). While amnesias in general can involve either older memories or newly experienced events, patients with Korsakow syndrome have particular difficulty with recent or even present events. In severe cases, information cannot be retained for even a few seconds. The resulting gaps are then filled with old or made-up memories. In addition to such pure memory gaps, Korsakow’s syndrome may also be accompanied by severe fatigue, mood swings, and motor disturbances. It is not uncommon for Korsakow’s disease to develop as a result of alcoholism. In the chronic stage, the damage to the brain in this case is usually so severe that normal function cannot be restored.
Causes
In many known cases, Korsakow syndrome was caused by years of alcohol abuse. The condition is therefore also considered one of the most severe brain and memory impairments that can occur in association with alcoholism. However, it can also be caused by traumatic brain injury, poisoning, brain hemorrhage, or certain infectious diseases such as typhoid fever. Often, the actual Korsakow syndrome is preceded by a condition called Wernicke’s encephalopathy. This is a vitamin B1 deficiency that can also be caused by alcoholism (alcohol interferes with metabolism and thus the absorption and utilization of vitamin B1, among other things). Symptoms such as memory loss, motor disorders or eye twitching can be alleviated by increased administration of vitamin B1. If Wernicke’s encephalopathy remains untreated, it can progress to chronic Korsakow syndrome, which is much more difficult to treat.
Symptoms, complaints, and signs
Korsakow syndrome is a serious psychiatric syndrome that is most often triggered by excessive, long-term alcohol consumption, often in conjunction with malnutrition. Especially chronic alcohol abuse can trigger the syndrome. Poor nutrition, on the other hand, can further accelerate the syndrome. Even one-time alcohol excesses with a poor physical constitution can lead to a sudden onset. Korsakow’s syndrome is also a type of memory loss, which can vary in severity. While in many cases long-term memory is still in tact, short-term memory is significantly affected. Once Korsakow’s syndrome occurs in conjunction with an alcohol-related stroke or collapse, long-term memory loss can sometimes be noted as retrograde or anterograde amnesia. This is particularly reflected in the patient’s use of language, so that a more or less severe Wernicke’s aphasia may be added. Speech may sound washed out and include unmotivated repetition. Received speech information is not processed correctly or incompletely. This is primarily due to the Wernicke region of the brain. Much is quickly forgotten or does not reach the long-term memory, which can also be seen in the speech. Furthermore, there may be articulation problems, which, depending on their severity, resemble those of drinkers. Korsakow’s syndrome is considered irreversible after a certain recovery period of the patient. Affected individuals are considered to be in need of care, up to and including helplessness.
Diagnosis and course
The attending physician can diagnose Korsakow syndrome particularly on the basis of the severity of the memory impairment. Particularly if alcohol dependence is present, pronounced short-term memory disorders may indicate Korsakow syndrome. This is especially true if other symptoms such as a disturbed sense of time, motor disturbances or an increased sensation of cold are also present. To rule out other brain disorders, the individual’s medical history should be reviewed in detail. In addition, a computer tomography can take place, which provides information about the condition of the brain.A blood test determines whether a vitamin B1 deficiency is present. Damage already caused by Korsakow syndrome is generally considered irreparable. If early treatment takes place, the function of the affected brain regions can be improved, although not completely restored. Nevertheless, patients with Korsakow syndrome often remain a care recipient.
Complications
First and foremost, Korsakow syndrome results in very severe memory impairment. In this case, the affected person is usually unable to remember certain events and may deny that they have happened. It is therefore not uncommon for Korsakow’s syndrome to lead to psychological complaints or depression. It is also not uncommon for Korsakow’s syndrome to limit social contact. Likewise, the syndrome leads to severe fatigue and tiredness of the patient. It is not uncommon for those affected to also suffer from mood swings. The resilience of those affected also decreases sharply as a result of Korsakow’s syndrome, so that patients are usually no longer able to carry out the usual activities of everyday life. In most cases, it is also no longer possible to carry out professional activities due to the disease. As a rule, the further course of the syndrome depends on the extent of the damage. In some cases, treatment is no longer possible. In any case, patients have to stop alcohol abuse to prevent further damage. With the help of various therapies, certain memories can be restored. However, a complete cure cannot be guaranteed in this process.
When should you go to the doctor?
People who have consumed a large amount of alcohol daily over a long period of time should see a doctor. If these people experience memory disturbances in addition to withdrawal symptoms or problems coping with everyday life, a visit to the doctor is necessary. If experienced events, memories or newly acquired skills cannot be correctly recalled from memory, the affected person needs help. If memory gaps occur or personal facts can no longer be fully recalled, a doctor should be consulted. Sufferers of Korsakow’s syndrome are unable to remember new developments in their lives. Likewise, it is not possible for them to remember past events. Often they vehemently deny incidents. A doctor is needed so that a comprehensive investigation can be initiated. If confabulation develops, a condition in which existing memory gaps are filled by free thoughts and invented stories, a visit to the doctor must be made. Disturbances of orientation or a lack of physical hygiene are indications that point to irregularities. Is physician is to be visited, so that the concerning receives a sufficient medical supply. If the sufferer suffers from listlessness, lassitude or increased fatigue, a doctor should be consulted. If there is a depressed mood, changing mood patterns, apathy, loss of appetite, or other behavioral abnormalities, a physician should be consulted.
Treatment and therapy
If a patient is found to have the signs of Korsakow syndrome, it is highly likely that drug therapy will be initiated first. As part of this, the affected person is given high doses of thiamine (vitamin B1), which can be administered intravenously or in tablet form. If the disease is not yet very advanced, a rapid and significant improvement in health can be achieved in this way. In a chronic stage of Korsakow’s syndrome, drug therapy usually remains unsuccessful. Basically, the damage that has already occurred in the brain is considered irreparable, which means that full memory cannot be restored even by intensive therapy. However, there are approaches that can be used to improve the patient’s memory function. These include constant memory training, in which the patient is encouraged to remember in a playful manner. Reviewing one’s own biography can also be helpful. If an alcohol disorder is the cause of Korsakow’s syndrome, treatment of the same should take place in parallel to prevent further progression of the disease.
Outlook and prognosis
Korsakow syndrome is a brain disease. This is manifested by a decline in memory performance.Those affected fabricate some supposed memories. Often, brain inflammation occurs due to anorexia or years of alcohol abuse. The brain inflammation can precede the Korsakow syndrome. It is often triggered by a severe vitamin B deficiency. This is then referred to as Wernicke-Korsakow syndrome. This is only partially treatable and hardly revisable. Korsakow syndrome can also have causes that are not related to alcoholism. Causes of Korsakow syndrome include strokes, severe skull injuries, or tumor formations in the brain. Viral infections can also cause Korsakow syndrome. The prognosis for those affected is also poor in this case. The prospects for recovery depend in part on the severity of Korsakow syndrome. The more severe it is, the worse the prognosis. In less severe courses, the symptoms of Korsakow syndrome can be treated. However, they usually do not disappear completely. Memory performance remains permanently impaired. The disease is chronic. Most sufferers do not regain their usual state. Many patients with Korsakow’s syndrome require permanent care. However, in some, the confused state can be improved by administration of vitamin B1. The prognosis can be improved only if alcohol dependence, the precipitating underlying disease, or the eating disorder are permanently overcome.
Prevention
To prevent Korsakow syndrome (and avoid other sometimes life-threatening conditions), it is of course advisable to avoid alcohol abuse, especially over a long period of time. If a dependency already exists, it should be treated promptly so that severe and irreparable brain and memory disorders do not subsequently occur.
Aftercare
As part of the follow-up of Korsakow syndrome, it is fundamental to determine the patient’s current health status. This determination is made on an outpatient basis by neurological and psychological examinations. This will reveal the extent to which individual cognitive functional areas of the patient’s brain have been damaged. It will then be possible to highlight and describe the patient’s cognitive abilities and resources. With this starting point, individually tailored therapies are then possible. Speech therapy, memory therapy and physiotherapy measures can then very well maintain the patient’s identified abilities and resources for a long period of time. Thus, a loss of the patient’s remaining abilities can be counteracted. In addition, it is possible to establish a general stability of the patient and an improvement in the abilities to cope with everyday life through absolute abstinence from alcohol alone. Vitamin administration, such as vitamin B1, and sustained abstinence may result in slight progress in the patient. As a result, patients with Korsakow’s syndrome may be able to manage their daily lives to a large extent or partially with therapeutic support. Suitable residential and nursing facilities are available for this restricted way of life. Here, the patient is then offered ongoing therapy services that can continue to help maintain his or her abilities.
What you can do yourself
Accompanying drug therapy, the symptoms of Korsakow syndrome can be treated through lifestyle changes and targeted countermeasures. For example, constant memory training is recommended to consolidate and improve memory function. This can be done either under professional guidance or independently and helps the affected person to correct the damage that has already occurred. Working through one’s own biography has a similar effect. If an alcohol disorder is the cause of the disease, it must also be treated. The person affected should contact the relevant doctor for this and, if possible, also seek out a self-help group. Friends and relatives can be an important support in the treatment of alcohol addiction. If Korsakow’s syndrome is due to a vitamin B1 deficiency, a change in diet is necessary. If the cause is cerebral hemorrhage or poisoning, intensive medical treatment is necessary. This is best supported by rest and adherence to the diet recommended by the physician. Permanent damage is treated depending on the respective condition.For example, motor disorders can be counteracted with crutches and other aids, while chronic depression can be alleviated by means of intensive talk therapy and exercise.
