Korsakoffin

Korsakoffin is a term occasionally encountered as a variant spelling of Korsakoff's syndrome. In medical literature, the condition is usually referred to as Korsakoff syndrome or Korsakoff psychosis. It is a chronic neuropsychiatric disorder most often linked to severe thiamine (vitamin B1) deficiency, typically arising after an episode of Wernicke's encephalopathy or from prolonged malnutrition and heavy alcohol use.

The core feature of Korsakoff syndrome is profound anterograde amnesia, with impaired ability to form new memories. Retrograde amnesia can also be present, and many patients show confabulation—making up memories to fill gaps. Other cognitive domains, such as attention, executive function, and visuospatial skills, may be variably affected, while language can be relatively preserved in some cases. Insight is often reduced, and daily functioning depends heavily on external support and structured routines.

Pathophysiology involves damage to structures that support memory, particularly the mammillary bodies and thalamic nuclei, due to thiamine deficiency. This damage disrupts memory circuits, leading to the characteristic amnesia. The condition is most common in people with chronic alcoholism, but it can occur with any prolonged thiamine deficiency, including malnutrition, eating disorders, certain cancers, and after bariatric surgery.

Diagnosis relies on clinical history of substantial memory impairment, evidence of thiamine deficiency, and usually a history of risk factors such as heavy alcohol use or malnutrition. Neuroimaging may show midline brain lesions or atrophy but is not required for diagnosis.

Treatment focuses on thiamine replacement, abstinence from alcohol, nutritional rehabilitation, and cognitive support. While some improvement can occur, memory deficits are often persistent. Prevention hinges on early recognition and treatment of Wernicke's encephalopathy and addressing nutritional risk factors.