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KMID : 0377819910110030273
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Diagnosis and Treatment
1991 Volume.11 No. 3 p.273 ~ p.277
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KORSAKOFF´S PSYCHOSIS
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임태식/Lim, Tae Shik
김광수/유태열/Kim, Kwang Soo/Lew, Tae Yul
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Abstract
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Alcohol ingestion must surely be the most common toxin to which people freely expose themselves worldwide. The effects of this expo-sure may be grouped into acute intoxication and withdrawal, and the wide-ranging syndromes of chronic use, usually with poor nutritional status. Chronic abuse sets the stage for the´ Wernicke-Korsakoff syndrome, Marchiafava-Bignami syndrome, cerebral atrophy, cerebellar degeneration, central Pontine myelinosis, nutritional neuropathy, and amyotrophy.
In the malnutritional state that usually accompanies chronic alcohol abuse, several distinctive disorders have been encountered. The most serious is the Wernicke-Korsakoff syndrome, attributed to La ;ncy of thiamine and B vitamins arising from poor nutrition and malabsorption,in alcoholics but also occasionally in non alcohalic patients. The acute stage of the syndrome, which often has a fairly abrupt onset, is referred to as Wernickes, encephalopathy. Korsakoff´s psychosis, the chronic phase of this syndrome, is characterized by anterograde and retrograde amnesia, deceased insight, apathy, and a striking inability to learn new inf ormation. Confabulation(unconscious fabrication of facts because of memory impairment ) is often, but not invariably, present early and´ is usually abscent in the chronic state of the disease. Once Korsakoff´s psychosis is emerges, the prognosis for recovery is poor, with only 20 % of patients making a substantial improve ment. The memor disorder may be related to bilateral degeneration of the dorsomedial thalamic nuclei.
Korsakoff´s psychosis can be a devastating illness that often requites institutionalization. Korsakoff´s and alcoholc dementia may occur in combination and may be difficult to sperate clinically. Therapy consists of an adequate diet with supplementation of thiamine. Unfortunately, none of the specific pharmacological approaches is terribly effective. We have experienced a case of Alcoholic Korsakoff´s psychosis and report it with a brief review of literatures.
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