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A spectrum of Alcohol Related Brain Damage…

Korsakoff’s Syndrome is part of the spectrum of Alcohol Related Brain Damage (ARBD) which merge and overlap and includes alcohol dementia; Wernicke’s encephalopathy; alcohol-related brain injury and alcoholic amnesic syndrome.

Wernicke-Korsakoff Syndrome is mainly developed as a result of malnutrition caused by heavy drinking over time – however it is also possible to develop Wernicke-Korsakoff Syndrome via other causes.

The diagnosis ‘Korsakoff’s Syndrome’ is generally used to describe people who have difficulties with memory but whose other mental abilities are unaffected. ‘Alcohol dementia’ may be used when there is a more general decline in ability.

 

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The range of damage can be from mild to very severe but generally does not degenerate if abstinence and good nutrition are maintained

ARBD

Common signs for ARBD
Cognitive and memory problems such as:

  • Confusion about time and place
  • Impaired attention and concentration
  • Difficulty in processing new information both verbal and visual
  • Inability to screen out irrelevant information
  • Confabulation used to fill gaps in context and memory creating inaccurate accounts of recent or past events
  • Apathy depression and irritability

Physical problems such as:

  • Poor balance and ataxia – which may or may not improve
  • Damage to gastric system liver and pancreas
  • Traumatic brain injury causing further damage
  • Peripheral neuropathy – numbness pins and needles burning sensations or pain in hands feet and legs
  • Visual disturbance – nystagmus

Wernicke’s Encephalophy

Symptoms:

  • Confusion about time and place
  • Drowsiness
  • Poor balance
  • Double vision
  • Abnormal eye movements

Causes:

  • Very poor nutrition/damage to stomach or liver.
  • Poor absorption of thiamine leading to the breakdown of blood vessels in the brain causing leakage of blood through the capillaries affecting the parts of the brain that forms new memories and controls muscle co-ordination.

Treatment:

  • High dose intramuscular or intravenous thiamine (vitamin B1).

Prognosis:

  • If treatment is commenced quickly and effectively there may be a full recovery although this is not guaranteed.
  • If treatment is delayed and the person becomes unconscious it is more likely that permanent damage is sustained and will begin to show signs of Korsakoff’s Syndrome.

Korsakoff’s Syndrome –
What is Affected?

Memory:

  • Short-term memory loss – unable to retain new information and form new memories.
  • Confabulation – filling in the gaps with made-up memories and fantasies. Gaps in memory may be filled with constructions around real events but out of sequence and inaccurate. There may be delusions about the past.

Other impairments:

  • Loss of spontaneity and initiative Lack of insight into their condition and how it may have developed. Unrealistic expectation of their condition.
  • Cognitive impairment – a deterioration in the ability to think or understand.
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