Which of the following is not seen in Korsakoff’s syndrome? (Repeat)
Correct Answer: Hallucinations
Description: Ans: C (Hallucinations) Ref: Synopsis of psychiatry, Kaplan & Sadock, 10th editionExplanationWernicke's encephalopathyIt is a condition which is acute in onset (cf. Korsakoff psychosis is insidious)It is characterized by the triad:Confusion (delirium tremens)Ataxia (in-coordination of movements)Nystagmus (due to opthalmoplegia and i or vestibular dysfunction). Chronic alcohol intake depletes thiamine (Vitamin B1) by various mechanisms.During acute intoxication, such deficiency results in degeneration of paraventricular regions of brain (mammillary bodies, thalamus and hypothalamus).The treatment is THIAMINE' IV 250-500mg/ day as slow- infusion for first five days, follow ed by oral route (lOOmg tds) for at least 15days.It is reversible if treated early.Otherwise, the condition progresses into "Korsakoff's psychosis", which is characterized by amnesia (both anterograde & retrograde) , confabulation (to fill up the gaps in memory), apathy & lack of insight.Less than 20% only respond to thiamine and often need as long as two years to show moderate improvement.Other neuropsvchiatric disorders due to alcohol are:Cerebellar degeneration,Central Pontine Myelinosis &Corpus callosum demyelination (Marchiafava- Bignanii disease).Riboflavin deficiencyMucositis (Cbelitis, Stomatitis, Glossitis)Dermatitis (Seborrheic)Normochromic, normocytic anemia.Folate deficiency - Depression.Vitamin BI2* Depression & Psychosis (both folate and Vit.B 12 cause mental disorders either directly or by increasing homocysteine levels in brain).
Category:
Psychiatry
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