About korsakovKorsakov syndrome The Korsakov (Korsakow or Korsakoff) syndrome was first described in 1852 by the Swedish doctor Magnus Hess. The Russian psychiatrist Sergei Korsakov - sometimes written as Korsakow or Korsakoff - described the syndrome in a series of six articles, published between 1887 and 1891, in a much more precise and therefore more influential way. Thus his name became linked to the syndrome. The direct cause of this syndrome is a serious deficiency of thiamine or vitamin B1, but in the Netherlands this almost exclusively occurs with alcoholics. Korsakov was however not aware that a vitamin B1 deficiency was the cause of the memory failure or behaviour problems he described: this was only discovered in 1947. He had however noticed that most of the patients were serious alcoholics.
There are presently about 8,000 Korsakov patients in the Netherlands and there are indications that this number is increasing. The syndrome seems to be becoming more apparent in younger people and the effects at the time of admittance to hospital are more serious than they were ten years ago. Another trend is the rapid increase in the number of female Korsakov patients. They are catching up, because until recently men accounted for three quarters of the number of patients. The Korsakov syndrome is an affliction of a part of the brain. This causes memory loss. The patient loses the ability to learn something new, and often the concept of time is disturbed. The behaviour of the patient changes, and they can no longer look after themselves. The cause of the affliction is long term misuse of alcohol, often in combination with poor diet. As a result, in addition to the Korsakov syndrome, other deterioration occurs to organs such as the liver, heart, pancreas or nervous system causing impairment of speech, movement, feeling and vision.
Who can be affected? It is assumed that everyone who for years drinks too much alcohol, both men and women, can be struck by the Korsakov syndrome. Because of the high consumption of alcohol by young people, the average age of Korsakov patients is decreasing. It is therefore not the case that only "older drinkers" are affected by the disease.
What are the precedents? There is often a long period of suffering in a family or relatives prior to a definite diagnosis of "Korsakov". It is a period during which the patient consumes excessive amounts of alcohol (often out of sight of the family). The normal way of life in the family or with relatives in due course becomes seriously disturbed. It is increasingly difficult to make arrangements with the patient. Financial matters often cause disagreements. The circle of friends becomes smaller. Perhaps even loss of a job is a precursor. Often there are arguments in the family or with relatives concerning the seriousness and consequences of drink abuse. There is always the hope that matters will improve and that the patient will stop drinking.
Once the diagnosis syndrome of Korsakov has been established, a period of denial sets in with the family of the patient. Despite all the misery, people continue to feel responsible for the patient. They search for reasons to demonstrate that it is all not true and that their own patient is not in such a bad way. It is normal that a Korsakov patient has periods of improvement and periods of deterioration. Moreover the patient has no understanding of his or her situation and denies that there is anything wrong. Many Korsakov patients can use their imagination, in other words fill the gaps in their memory with fantasy stories. Both for an outsider and also for professionals it is difficult to recognize the reality. The fantasy sounds in many cases quite plausible, but sometimes it seems as if the patient is consciously lying. The behaviour of the Korsakov patient makes living together very difficult, but living independently is impossible for the patient. The Korsakov Stichting has a separate brochure entitled "Life with a Korsakov patient".
Is there a chance of recovery? No! The human body can recover from much damage, but not from injured brain cells. Medicine offers no chance of healing. It is not anticipated that new medicines or methods will be discovered. The medicines dispensed to the patient can sometimes help to alleviate other effects of misuse of alcohol or to influence disturbed behaviour. What is possible? Sometimes after admittance there can be some improvement in the condition of the patient. Admittance and guidance of patients and family takes place in general- and psychiatric hospitals, psycho-geriatric nursing homes and protected living units. Several institutes are specialized in the admittance and guidance of Korsakov patients and sometimes have a separate Korsakov department. |
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