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What is Korsakoff's syndrome?

Korsakoff’s syndrome is a disease of the central nervous system characterized by short term memory loss. The commonest cause of Korsakoff’s syndrome is alcoholism, although a number of different illnesses can be responsible. The mediating factor which is central to the occurrence of Korsakoff’s syndrome for all these illnesses, is very low levels of vitamin B1, also known as thiamine.

How does Korsakoff’s syndrome present?

The brain damage associated with Korsakoff’s syndrome may be fatal, and if not fatal be associated with the occurrence of dementia. However, the factor which differentiates Korsakoff’s syndrome itself from dementia is the marked short-term memory loss which occurs as a result of damage to specific brain areas. Korsakoff’s syndrome has a marked effect on brain areas responsible for short-term memory functions such as the mamillary bodies and lining of the cavities in the brain known as ventricles. This damage results in the disabling short-term memory loss typical of Korsakoff’s syndrome. Patients typically are unable to remember what they had for breakfast, but will remember in perfect detail the events of many years before.

What can be done to prevent Korsakoff’s syndrome?

Any one at risk of developing Korsakoff’s syndrome, especially alcoholics, should be observed for the early signs of development. Early signs of Korsakoff’s syndrome (more correctly known as Wernicke’s syndrome for early signs) include confusion and disorientation, a staggering gait and in some cases paralysis of eye muscles leading to a squint. Raised temperature and raised blood pressure may also be indicative of signs of a developing Korsakoff’s syndrome. If the development of Korsakoff’s syndrome is suspected, then patient should be treated as a medical emergency and given intravenous vitamin B1 (thiamine).

What can be done to treat established Korsakoff’s syndrome?

Once Korsakoff’s syndrome has become established, a small degree of recovery may occur over a period of years, but this seems unusual. The most effective treatment for established Korsakoff’s syndrome is social treatment aimed at retraining the person to deal with their memory loss. Practical examples include the routine keeping and up-dating of lists, or maintenance of photographs of individuals with names, or other measures aimed at overcoming the debilitating short term memory loss associated with Korsakoff’s syndrome.

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