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Monthly Observance

(Cerebral Beriberi; Korsakoff's Amnesic Syndrome)

Definition

Korsakoff's syndrome is a group of symptoms that affect memory, usually in patients with alcoholism. It often occurs following Wernicke encephalopathy.
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Causes

Korsakoff syndrome is caused by a lack of vitamin B1, also known as thiamine. This is also always associated with alcoholism, since a poor diet and alcohol can prevent the body from getting enough thiamine.
Not everyone with alcoholism develops Korsakoff syndrome. A combination of genes and diet may play a role.

Risk Factors

Factors that increase your chance of developing Korsakoff's syndrome include:
  • Alcohol abuse
  • Malnutrition

Symptoms

Symptoms of Korsakoff syndrome may include:
  • Confusion
  • Memory problems
  • Learning difficulty
  • Communication problems
  • Difficulty concentrating
  • Difficulty with walking and balance
The main symptom of Korsakoff's syndrome is severe memory problems. It is most obvious 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 are not usually affected. To fill in the gaps in recent memory, patients tend to make up information that fits with the situation. This is called confabulation.

Diagnosis

You will be asked about your symptoms and medical history. Your mental function will be assessed. Testing your ability to learn new information most likely will show if you have this condition. If you are an alcoholic and/or have had Wernicke's syndrome, Korsakoff's syndrome is seriously considered as the cause of your memory problem.

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

Rehabilitation

You may be referred to an alcohol rehabilitation facility if alcoholism is the cause of your condition.

Thiamine Supplements

You will be given thiamine to treat the thiamine deficiency.

Dietary Changes

You will need to drink plenty of fluids. You may also be referred to a dietitian to help with meal planning, especially if your diet is high in carbohydrates.

Prevention

Korsakoff syndrome often occurs following Wernicke encephalopathy. To reduce your risk:
  • Ensure that you are getting enough thiamine in your diet. This is 1.1 mg a day for women and 1.2 mg a day for men. Foods that are rich in thiamine include lentils, peas, fortified breakfast cereal, pecans, spinach, oranges, milk, and eggs.
  • Do not drink alcohol or only drink in moderation.
  • If you have a drinking problem, talk to your doctor right away about treatment options.

RESOURCES

Alcoholics Anonymous http://www.aa.org

National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov

CANADIAN RESOURCES

Alcoholics Anonymous Canada http://www.aacanada.com

Dietitians of Canada http://www.dietitians.ca

References

Harper C. Thiamine deficiency and associated brain damage is still common throughout the world and prevention is simple and safe. Eur J Neurol. 2006,13:1078-1082.

Impairments of brain and behavior: the neurological effects of alcohol. Alcohol Health and Research World.1997;1:21.

Korsakoff syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 16, 2012. Accessed December 19, 2013.

Kuo SH, Debnam JM, et al. Wernicke's encephalopathy: an underrecognized and reversible cause of confusional state in cancer patients. Oncology. 2009;76(1):10-18.

Lukas RV, Piantino J, et al. MRI changes in a head and neck cancer patient with Wernicke’s Encephalopathy and visual loss. Neuro-Ophthalmology. 2011;35(5-6):272-275.

Thomson AD, Marshall EJ. The natural history and pathophysiology of Wernicke’s encephalopathy and Korsakoff’s psychosis. Alcohol Alcohol. 2006,41:151.

Yoon CK, Chang MH, et al. Wernicke-Korsakoff syndrome associated with hyperemesis gravidarum. Korean J Ophthalmol. 2005;19(3):239-242.

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