What Is Korsakoff’s Syndrome?
Korsakoff’s syndrome is a memory disorder commonly caused by excessive alcohol consumption and is thought of as a type of alcohol-related brain damage.
Classed as a form of dementia, it exists on a spectrum and ranges from mild to extremely severe.
People with Korsakoff’s syndrome experience significant memory loss and trouble with comprehension and learning.
It’s thought that this syndrome accounts for up to 10% of all dementias in younger people across the UK and can lead to a life-long condition or even be fatal is not properly treated and managed. 
Korsakoff’s syndrome is often referred to as Wernicke-Korsakoff syndrome as it can develop if a neurological disorder known as Wernicke’s encephalopathy is left untreated over a period of time.
What causes Korsakoff’s syndrome?
Korsakoff’s syndrome is caused by a lack of thiamine (also known as vitamin B1) in the body, and this deficiency is most commonly due to alcohol abuse as people with alcohol addiction are more prone to vomiting and malnutrition. 
Alcohol also makes it more difficult for the body to absorb and store vitamin B1, so any small amounts gained from food are quickly processed and discarded without medical intervention.
However, alcohol consumption is not the only cause of Korsakoff’s syndrome.
If a condition or illness has the ability to disrupt the absorption of certain vitamins then it is possible that it could be the cause of this syndrome.
Common causes of Korsakoff’s syndrome include:
- Excessive alcohol consumption
- Anorexia and bulimia
- Gastric bypass surgery
- Extreme morning sickness during pregnancy that causes excessive vomiting
- HIV and AIDS
- Certain types of cancer including gastric cancer and colon cancer
The body needs thiamine in order to successfully convert food into energy, and it does not have the ability to produce this essential vitamin itself.
Without thiamine, the brain and body are unable to function effectively and in severe causes this deficiency can lead to death.
What are the symptoms of Korsakoff’s syndrome?
In general, symptoms of Korsakoff’s syndrome are fairly noticeable and mainly focused on learning, memory and comprehension,
People with this syndrome have trouble forming new memories as well as recalling short and long-term memories, and often attempt to fill in the gaps with false memories that they believe to be real.
If you are concerned that you or someone you know may be suffering from Korsakoff’s syndrome, keep an eye out for the below symptoms.
Common symptoms of Korsakoff’s syndrome include:
- Visual and auditory hallucinations
- Large gaps in memory
- Difficulty remembering recent events
- Filling in the gaps with incorrect information, but believing that this information is true
- Trouble understanding and comprehending information
- Unable to quickly make decisions or plan for future events
- Difficulty concentrating
- Frequent confusion
- Repeating the same question or statement multiple times
- Finding it difficult to solve even small problems
- Believing that nothing is wrong with their memory
- Noticeable change in personality – becoming quieter or more talkative
- Trouble learning new skills and information
People with Korsakoff’s syndrome may frequently appear confused and seem less able to comprehend what they are learning.
However, some people may be able to hold a completely normal conversation, although they are likely to forget parts or even all of this conversation a short time later.
How is Korsakoff’s syndrome diagnosed?
It can often be difficult to professionally diagnose a patient with Korsakoff’s syndrome as the symptoms can be similar to other alcohol-related problems such as head injuries or alcohol withdrawal.
Additionally, no specific tests or procedures to diagnose Korsakoff’s syndrome currently exist, make it more of a challenge for patients to receive a diagnosis. 
Many people are only diagnosed with Korsakoff’s syndrome after entering the hospital for unrelated treatment, primarily related to their alcohol addiction.
In order to make a diagnosis, a doctor will ask a series of questions to determine the patient’s memory function and conduct tests in order to rule out other potential disorders.
They will ask a number of questions regarding the patient’s alcohol use and drinking habits along with their general nutritional health, while also running blood and liver tests and in some cases detailed brain scans.
It can also be helpful to test the levels of thiamine in the patient’s blood to give a more accurate diagnosis of Korsakoff’s syndrome.
How is Korsakoff’s syndrome treated?
Once a diagnosis of Korsakoff’s syndrome has been obtained, the supplementation of thiamine should begin immediately.
These supplements should be delivered intravenously as people dealing with this syndrome often have trouble absorbing vitamins and nutrients that are consumed orally.
It is recommended to avoid alcohol after a diagnosis of Korsakoff’s syndrome, and patients are advised to undergo professional alcohol detoxification followed by counselling once their thiamine levels are at a manageable level.
They are also encouraged to follow a healthy and varied diet rich in essential vitamins and minerals.
In cases of malnutrition, patients will also be supplemented with a range of vitamins including all B vitamins until their levels are sufficiently increased.
It is also advised that anyone with a history of excessive alcohol consumption or other risk factors who begins to show signs of Korsakoff’s syndrome should be prescribed thiamine injections even without a professional diagnosis.
This can help to prevent the symptoms from becoming more debilitating and potentially reverse the damage that has already been done.
Is Korsakoff’s syndrome permanent?
In some cases, Korsakoff’s syndrome develops after the onset of Wernicke encephalopathy, a related disorder that can progress into the more serious Korsakoff’s syndrome if left untreated.
However, in 20% of cases, Wernicke encephalopathy can cause death even before Korsakoff’s syndrome develops.
It is possible to recover from Korsakoff’s syndrome and live a relatively normal life, with 25% of patients thought to completely recover and around 50% of patients showing improvement.
There are positive signs around behaviour change, with some studies showing that avoiding alcohol after developing Korsakoff’s syndrome can result in a normal life expectancy.
However, more research is required to understand more about this syndrome and its long-term prognosis.