Korsakoff's syndrome (amnesic psychosis)

An alcoholic amnestic syndrome often coexistent with Wernike's syndrome. Etiology: 1) chronic alcoholism a) severe of repeated episodes of delirium tremens b) Wernicke's encephalopathy 2) nutritional deficiencies 3) bilateral lesions of the hippocampus a) contusions b) hematoma c) hemorrhagic stroke Epidemiology: > 40 years of age Clinical manifestations: 1) confusion 2) severe memory impairment a) especially for recent events b) mixed anterograde & retrograde amnesia 3) confabulation 4) disorientation 5) emotional changes 6) apathy 7) blandness 8) euphoria despite environmental events 9) polyneuritis 10) delirium tremens may precede Korsakoff's syndrome Management: 1) prognosis a) poor if thiamine-associated, < 20% recovery b) good if due to head injury or subarachnoid hemorrhage -> improvement may be seen for 12-24 months 2) institutionalize patient 3) pharmaceutical agents a) clonidine b) propranolol

General

psychosis syndrome

References

Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995