confabulaties

Confabulations are false or distorted memories or statements presented as true by the speaker, typically without conscious intent to mislead. They arise most often in the context of memory disorders or brain injury and reflect gaps in memory, attention, or source monitoring rather than deception.

Confabulations can be classified as provoked (or prompted) and unprovoked (or spontaneous). Provoked confabulations occur when a person is asked to recall an event and supplies inaccurate details; unprovoked confabulations are elaborated, sometimes lengthy narratives that a person believes to be true. Simple confabulations are brief and plausible, while complex ones are longer and more elaborate. Some cases are described as delusional confabulations when the false memory is held with strong conviction.

Causes and neuroanatomy: Confabulations are commonly associated with Korsakoff syndrome from thiamine deficiency, Alzheimer's disease and other dementias, traumatic brain injury, stroke, or damage to frontal and thalamic circuits (including the mamillary bodies). They reflect impaired memory encoding, impaired source monitoring, and disrupted reality monitoring.

Clinical features and evaluation: They may involve memories of events that never occurred or distorted versions of real events. They can impede daily functioning and safety. Diagnosis relies on clinical history, neuropsychological testing, and assessment of consistency with known facts; imaging may reveal underlying pathology.

Management: Treatment focuses on the underlying condition (for example, nutritional rehabilitation and abstinence in Korsakoff syndrome; management of dementia; rehabilitation after brain injury). Cognitive strategies, environmental supports, and caregiver education can help reduce confabulations. There is no specific medication for confabulations per se; addressing memory and executive function deficits can improve overall outcomes.