Home
Amnsetic Syndrome
|
|
A syndrome of memory loss with relative sparing of intellect and personality. The memory deficit is mainly of new learning.
Clinical features:
- New learning is lost but immediate memory is intact enabling the patient to carry a conversation. Insight is often lacking and the patient may compensate for the failure of memory by confabulating. The individual cannot recall events that occurred subsequent to the time of onset of the illness (anterograde amnesia).
- The onset is usually sudden and once established treatment brings improvement only to a minority. It is usually a persistent disorder.
Aetiology:
- Thiamine deficiency due to chronic alcoholism, malnutrition, hyper-emesis gravida, Ca stomach etc. (Where thiamine deficiency is the cause the syndrome may be preceded by Wernicke's encephalopathy which is characterised by confusion, ataxia, ocular palsies, nystagmus and peripheral neuropathy. This condition passes after a number of weeks often leaving a dysmnestic syndrome. The term Korsakoff's syndrome is often used in this context.)
- Herpes encephalitis.
- Tumours.
- Trauma.
- Subarachnoid haemorrhage.
- Carbon-monoxide poisoning.
Pathology.
- Punctate haemorrhage in the mamillary bodies and diencephalon are found in the Korsakoff syndrome.
- Bilateral hippocampal damage, as occurs with post encephalitic states.
Treatment.
- Treat the underlying pathology.
- Prevent Wernicke-Korsakoff syndrome by treating alcoholics with large doses of thiamine and other B vitamins. (Remember that there are other causes of Wernicke-Korsakoff syndrome and consider treating individuals with these disorders too.)
- Supportive measures once the syndrome has become fixed.
This work is licenced under a Creative Commons Licence.