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Understanding Korsakoff’s Syndrome

Heavy drinking can be a slippery slope.

On the surface, there may not appear to be any problems or consequences when going out drinking. Everyone should be able to go out, enjoy a few drinks safely and have a good time. Drinking is and probably always will be a popular past time, so long as it is done safely.

However, it is not uncommon for people’s drinking to get out of hand. Sometimes people develop drinking problems and the consequences can manifest in some serious ways. Every day we are seeing examples of people getting DUI’s and maybe even being forced to attend an inpatient drug rehab because of a court order from a DUI.

These are serious consequences for sure, but another consequence of heavy drinking can lead to even worse long term effects.

Some heavy drinkers develop a brain disorder called Korsakoff’s syndrome. Anyone who does too much heavy drinking (or if you know of someone who drinks too much) should be aware of this disorder and what some of the long-term effects may be.

What Is Korsakoff’s Syndrome?

Korsakoff’s Syndrome is a brain disorder that is usually found in people that have done a lot of heavy drinking over a sustained period of time, usually over the course of years or even decades. The disorder has terrible effects on people and their short term memory, especially developing new memories and being able to access them later.

Although Korsakoff’s Syndrome is not very common, it does show up in enough people that it is considered problematic. The disorder can be found in about 1 in every 8 alcoholics, which is about 2% of our total population.

The heavy drinking itself does not cause Korsakoff’s syndrome, rather it is a symptom of a deficiency of thiamine, commonly known as vitamin B12. B12 is very important in the role of cognitive functions. The deficiency of thiamine is common in alcoholics for a few reasons, but it is mainly a combination of poor lifestyle choices, frequent vomiting and alcohol’s ability to block nutrient absorption.

Why Would Alcohol Cause a Deficiency in Thiamine?

The root of this deficiency in thiamine is because many heavy drinkers have poor dietary habits and what they are consuming does not contain the essential nutrients. Alcohol can block the absorption of thiamine and therefore the conversion of the vitamin to its’ active form does not occur. Also, alcohol can cause inflammation in the stomach lining and as a result frequent vomiting can occur. As a result, key vitamins essential for proper nutrition are not absorbed and it makes it harder for the liver to store these vitamins.

Alcohol blocks the absorption of thiamine and therefore the conversion of the vitamin to its active form does not occur. Also, alcohol can cause inflammation in the stomach lining and as a result frequent vomiting can occur. Key vitamins essential for proper nutrition are not absorbed and it makes it harder for the liver to store these vitamins.

Development

Korsakoff’s Syndrome is a part of a larger condition known as Wernicke-Korsakoff’s syndrome which consists of two separate stages. The first stage of the disorder is known as Wernicke’s encephalopathy, which is followed by Korsakoff’s Syndrome. Wernicke’s encephalopathy usually develops suddenly and in some cases there may be no obvious symptoms which can make it difficult to diagnose. There are four groups of symptoms that accompany this encephalopathy which are;

Evidence of undernutrition

  • Involuntary, jerky eye movements and/or paralysis of the muscles that move the eyes
  • Poor balance or unsteadiness
  • Disorientation, confusion, or mild memory loss.

If Wernicke’s encephalopathy is suspected, immediate treatment is essential. If treatment is carried out in time (within a few days of diagnosis) most of the symptoms can be reversed. However, if left untreated, Korsakoff’s Syndrome usually follows. Korsakoff’s Syndrome, unlike Wernicke’s, develops gradually. Damage associated with Korsakoff’s Syndrome is usually concentrated in the part of the brain responsible for short-term memory. Despite the impact on short-term memory, working memory among other abilities remain intact.

The main symptom of Korsakoff’s Syndrome is memory loss. As is the case with many memory related disorders, the patient will also have a hard time developing new memories, skills and will develop many changes in personality.

Also, an individual may not have insight into their condition even when large gaps in memory are noticed by that individual. Because of those gaps, a person will invent events in order those in, which otherwise is known as confabulation.

Diagnosis and Treatment

Korsakoff’s syndrome cannot be diagnosed until a person has stopped drinking for a period of several weeks. The administration of a physical exam, along with performing lab tests and taking a medical history are important steps. In addition, psychological testing of memory and other abilities will be performed. The individual with Korsakoff’s Syndrome will be observed to see if their condition improves or worsens without alcohol. If the symptomology associated with Korsakoff’s Syndrome worsens, another form of dementia such as Alzheimer’s disease may be diagnosed.

Symptoms associated with Korsakoff’s Syndrome can be halted over time if a person is given high doses of thiamine, as well as abstaining from alcohol and adopts a healthy diet. Improvement is usually gradual with the average time occurring within a period of two years. About one in four make a good recovery and about half make a partial recovery and need support while another quarter of those affected generally need longer term care.

Stay Vigilant with Your Drinking

An easy way to monitor your drinking is by checking your blood alcohol level. As we said earlier in this article, enjoying a few drinks and even becoming intoxicated is perfectly okay. There is a balance that should be maintained to avoid any real consequences.

Carrying a blood alcohol tester is a great idea. You can always monitor your BAC to ensure that you are not over the limit to drive or that you are not putting yourself in a position to cause any real damage to your body.

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