Psychiatry - G.T. Sonnyk 2003

General Psychopathology and Symptomatology of Mental Illnesses
Korsakoff's Amnestic Syndrome

This is a syndrome of organic Brain damage. It is a combination of fixation amnesia (memory impairment for current events), disorientation in place and time, and confabulations. It was first described by Korsakoff in 1887.

Memory disorders primarily affect the retention of current and recent events. Patients almost immediately forget newly acquired impressions, sometimes within mere seconds. The patient does not remember who they spoke with today, what they ate or whether they ate at all, how long they have been ill, and how much time they have spent in the hospital. They constantly retell the same stories and repeat identical questions. Verbal memory is impaired to the greatest extent, whereas affective memory (for events associated with unpleasant experiences for the patient) is less affected. Memory for past life events is generally preserved reasonably well.

Disorientation disorders vary in severity. Disorientation in time is the most profoundly affected. Patients are often unable to name not only the date, day of the week, and month, but even the season of the year and the current year. Orientation in place and space is also significantly impaired. As a result, the patient is unable to find the necessary room in the ward, and does not know the Location of their bed, the restroom, etc.

Confabulations typically arise in response to direct questions rather than spontaneously. Their content mostly relates to past events in the patient's life and professional activities. Fantastic confabulations are observed much less frequently. The intensity of confabulations increases in proportion to the patient's age.

Alongside these symptoms, patients with Korsakoff's syndrome invariably exhibit some degree of cognitive decline, including impaired insight into their own condition. At the same time, certain knowledge and skills remain quite well preserved (professional expertise, The ability to play chess, cards, etc.). The personality Structure is also moderately affected: despite diminished self-awareness, patients are always aware of having an illness and often dissimulate their memory deficits.

Patients with Korsakoff's syndrome consistently exhibit a reduced level of drives and activity. Physical and mental fatigue can be constantly observed, which is more pronounced in older age. The age factor also determines the prevailing affect: in elderly individuals, it is more often depressed, accompanied by periods of anxiety and hypochondriacal concerns; in young and middle-aged patients, it manifests as euphoria alternating with irritability.

In the majority of cases, Korsakoff's syndrome develops acutely following a state of altered consciousness, most commonly delirium. Much less frequently, it arises after a stupor or twilight states of consciousness. A gradual onset of Korsakoff's syndrome without a preceding period of altered consciousness is encountered primarily in old age against the Background of senile-atrophic processes, cerebral atherosclerosis, or chronic intoxications (such as alcohol).

Korsakoff's syndrome is observed in various types of intoxication (primarily alcoholism), following TRAUMATIC BRAIN INJURIES, in Brain Tumors and infectious diseases, after acute Hypoxia (Carbon monoxide poisoning, hanging), and in senile-atrophic and vascular processes.