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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
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| {{Infobox_Disease |
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| Name = {{PAGENAME}} |
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| Image = Thiamine-2D-skeletal.png |
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| Caption = [[Thiamine]] |
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| DiseasesDB = 14107 |
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| ICD10 = {{ICD10|F|10||f|10}}6 |
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| ICD9 = {{ICD9|291.1}}, {{ICD9|294.0}} |
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| ICDO = |
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| OMIM = |
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| MedlinePlus = |
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| eMedicineSubj = med |
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| eMedicineTopic = 2405 |
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| MeshID = D020915 |
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| }}
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| {{SI}}
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| {{CMG}}
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| {{EH}}
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| ==Overview==
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| '''Korsakoff's syndrome''' ('''Korsakoff's psychosis''', '''amnesic-confabulatory syndrome''') or '''Wernicke's encephalopathy''' is a degenerative brain disorder caused by the lack of [[thiamine|thiamine (vitamin B<sub>1</sub>)]] in the [[brain]]. The [[syndrome]] is named after [[Sergei Korsakoff]], the [[Neuropsychiatry|neuropsychiatrist]] who popularized the theory.
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| It may result from alcohol abuse, dietary deficiencies, prolonged vomiting, eating disorders, or the effects of chemotherapy. Symptoms include mental confusion, vision impairment, stupor, coma, hypothermia, hypotension, and ataxia. Korsakoff's amnesic syndrome-a memory disorder-also results from a deficiency of thiamine, and is associated with alcoholism. The heart, vascular, and nervous system are involved. Symptoms include amnesia, confabulation, attention deficit, disorientation, and vision impairment. The main features of Korsakoff's amnesic syndrome are the impairments in acquiring new information or establishing new memories, and in retrieving previous memories. Although Wernicke's and Korsakoff's may appear to be two different disorders, they are generally considered to be different stages of the same disorder, which is called Wernicke-Korsakoff syndrome. Wernicke's encephalopathy represents the "acute" phase of the disorder, and Korsakoff's amnesic syndrome represents the "chronic" phase.
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| ==Symptoms==
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| There are six major symptoms of Korsakoff's syndrome:
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| # [[anterograde amnesia]] and
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| # [[retrograde amnesia]], severe memory loss
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| # [[confabulation]], that is, invented memories which are then taken as true due to gaps in memory sometimes associated with [[Blackout (Alcohol Related Amnesia)|blackouts]]
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| # meager content in [[conversation]]
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| # lack of insight
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| # [[apathy]] - the patients lose interest in things quickly and generally appear indifferent to change.
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| These symptoms are caused by a deficiency of [[thiamine|thiamine (vitamin B<sub>1</sub>)]], which is thought to cause damage to the [[medial]] [[thalamus]] and possibly to the [[mammillary bodies]] of the hypothalamus as well as generalized [[cerebral atrophy]].<ref>Kolb & Whishaw: ''Fundamentals of Human Neuropsychology'', 2003, pages 473-473</ref>
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| When [[Wernicke's encephalopathy]] accompanies Korsakoff's syndrome, the combination is called the [[Wernicke-Korsakoff syndrome]]. Korsakoff's is a continuum of Wernicke's encephalopathy, though a recognised episode of Wernicke's is not always obvious.
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| Korsakoff's involves neuronal loss, that is, damage to [[neurons]]; [[gliosis]] which is a result of damage to supporting cells of the [[central nervous system]]; and [[hemorrhage]] or bleeding in mammillary bodies. Damage to the dorsomedial nucleus of the [[thalamus]] is also associated with this disorder.
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| ===Signs===
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| * [[Ataxia]]
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| * [[Apathy]]
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| * Retrograde and anterograde amnesia
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| * [[Confabulation]]
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| * Tremors
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| * [[Paralysis]] of muscles controlling the eye
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| * Lack of insight to the condition
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| * [[Coma]]
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| ==Treatment==
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| Treatment involves replacing the [[thiamine]] by [[Intravenous]] (IV) or [[intramuscular]] (IM) injection, and providing proper [[nutrition]] and [[hydration]]. However, the amnesia and brain damage caused by the disease does not respond to [[thiamine]] replacement therapy. In some cases, [[drug therapy]] is recommended to the [[patient]]. If treatment is successful, signs will show within two years though recovery is slow and often incomplete.
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| ==Causes==
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| Conditions resulting in the vitamin deficiency and its effects include chronic [[alcoholism]], and severe [[malnutrition]]. Alcoholism is often an indicator of poor nutrition, which in addition to [[inflammation]] of the stomach lining, causes thiamine deficiency.<ref>http://www.alzheimers.org.uk/Facts_about_dementia/What_is_dementia/info_korsakoffs.htm</ref> As well as [[alcohol abuse]], causes include dietary deficiencies, prolonged vomiting, [[eating disorder]]s, or the effects of [[chemotherapy]]. It can also occur in pregnant women who have a form of extreme morning sickness known as [[hyperemesis gravidarum]].<ref>http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/korsakoffs_syndrome.jsp</ref> [[Mercury poisoning]] can also cause it.
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| Due to malnutrition and a lack of Thiamine, the [[hippocampus]] begins to decay, leaving holes that disallows one's rehearsed information within short term memory to transfer to long term memory ([[anterograde amnesia]])
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| ==References==
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| <references/>
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| == External links ==
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| *[http://www.untitledtheater.com/plays/strangers-linguish.html ''Strangers''] is a play by [http://www.untitledtheater.com/Edwardbio.htm Edward Einhorn] based on the syndrome.
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| * [http://www.merck.com/mrkshared/mmanual/home.jsp The Merck Manual]: [http://www.merck.com/mrkshared/mmanual/section14/chapter169/169.jsp Function And Dysfunction Of The Cerebral Lobes] - [http://www.merck.com/mrkshared/mmanual/section14/chapter169/169e.jsp Amnesias - Korsakoff's syndrome]
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| * [http://www.healthatoz.com/healthatoz/Atoz/ency/korsakoffs_syndrome.jsp Simple description of Korsakoff's syndrome]
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| {{Mental and behavioural disorders}}
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| {{SIB}}
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| [[Category:Memory disorders]]
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| [[Category:Neurology]]
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| [[Category:Malnutrition]]
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| [[Category:Syndromes]]
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| [[de:Korsakow-Syndrom]]
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| [[es:Síndrome de Korsakoff]]
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| [[fr:Syndrome de Korsakoff]]
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| [[it:Sindrome di Korsakov]]
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| [[nl:Syndroom van Korsakov]]
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| [[ja:コルサコフ症候群]]
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| [[pl:Zespół Korsakowa]]
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| [[pt:Síndrome de Korsakoff]]
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| [[ru:Синдром Корсакова]]
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