(Cerebral Beriberi; Korsakoff's Amnesic Syndrome; Wernicke-Korsakoff Syndrome)
Korsakoff's syndrome is a memory disorder caused by a lack of vitamin B1]]> (thiamine). 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.
In the US, the most common cause of thiamine 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 a chronic disease, such as ]]>AIDS]]> , are at an increased risk. The daily requirement of thiamine is 1-3 mg per day.
Thiamine 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. Age also appears to be a risk factor for developing Korsakoff’s syndrome. Alcoholics of more advanced age are more susceptible to developing the disorder. The direct effects of alcohol on nerves in the brain may also contribute.
These factors increase your chance of developing Korsakoff's syndrome. Tell your doctor if you have any of these risk factors:
- Genetic susceptibility
- Advanced age
- Persistent vomiting leading to malnutrition
- Conditions or procedures (eg, obesity surgery) that may lead to poor food intake or absorption of nutrients
The main symptoms of the related disorder, Wernicke's syndrome, occur acutely. They include:
- Difficulty with walking and balance
- Paralysis of some of the eye muscles
- Peripheral neuropathy]]>
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.
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 involves taking intravenous thiamine and drinking plenty of fluids right away. Because improvement is slow, you must supplement your diet with oral thiamine for many months. If alcoholism is the cause, you will also need treatment for that condition.
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.
- Do not drink alcohol or only drink in moderation.
- If you have a drinking problem, talk to your doctor right way about treatment options.
National Institute on Alcohol Abuse and Alcoholism
Dietitians of Canada
Ardila A. Korsakoff Syndrome. In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corporation. MedLink website. Available at: http://www.medlink.com . Accessed January 31, 2009.
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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.
The Merck Manual of Diagnosis and Therapy. Simon and Schuster, Inc; 1999.
National Institute on Alcohol Abuse and Alcoholism. National Institutes of Health (NIH) website. Available at: http://www.niaaa.nih.gov .
Thomson AD, Marshall EJ. The natural history and pathophysiology of Wernicke’s encephalopathy and Korsakoff’s psychosis. Alcohol Alcohol. 2006,41:151.
Last reviewed January 2009 by ]]>J. Thomas Megerian, MD, PhD, FAAP]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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