Korsakoff psychosis treatment. Korsakoff psychosis in alcoholism: symptoms and treatment of a dangerous disease

Today everyone has heard about the dangers of vitamin deficiency. For example, lack of strength and energy, drowsiness and increased fatigue often indicate a lack of vitamin B1 (thiamine) in the human body. However, few people know that a serious deficiency of this substance can lead to such severe consequences like a clouding of reason.

This type of mental disorder was first described in 1877 by the Russian psychiatrist S.S. Korsakov. The doctor called it “polyneuritic psychosis” - a combination of mental destruction and polyneuritis (lesions of the peripheral nervous system). The main symptoms of the disease were memory loss, disorientation in space and weakness of the limbs (paresis). Subsequently, in medicine this condition began to be called “Korsakov’s” psychosis.

Research by Sergei Korsakov, dedicated to the causes of alcoholism. It was he who managed to prove that alcoholism is a serious illness that can and should be treated.

Korsakoff psychosis can develop as a result of certain infections, severe poisoning, head injuries that provoked a serious deficiency of vitamin B1 (thiamine) and nicotinic acid in the human body. But most common cause Its origin is alcohol abuse.

Signs and symptoms

If the patient abuses alcohol Korsakov's psychosis in the initial phase can be confused with delirium tremens (delirium tremens): the patient loses adequacy, does not realize where he is, he is haunted by visual and auditory hallucinations, often of a threatening nature (a person hears aggressive voices, sees animals attacking him, etc.).

In the case of Korsakov psychosis, consciousness then clears up, but the patient does not remember the events before the attack. Amnesia can also be more extensive, when a person forgets, for example, members of his family and others significant events own life.

The patient also has following symptoms mental confusion:

his intellect is significantly weakened, the patient is unable to reason adequately;
talks about fictitious events that he perceives as having actually happened to him (for example, borrowing plots from TV shows or books);
“transfers” in his consciousness to the present time events that actually happened, but many years ago;
memory becomes selective: for example, a patient can adequately remember everything that happened before the illness and significantly distort what is happening in reality;
a person is not able to perceive unfamiliar information or adapt to new circumstances;
may lose basic skills and become helpless in everyday life;
not oriented in time and space;
the sensitivity of the nerve endings is lost - the patient does not feel touch, or feels tingling, numbness, goosebumps;
is in a depressed state;
experiences fear, with a confused consciousness, fusses excessively or, conversely, is apathetically inactive, the emotional background is extremely unstable;
healthy criticality of consciousness is replaced by unjustified euphoria;
observed severe weakness muscles, which leads a person to significant or complete loss of strength.

The combination of these signs indicates that the patient should be immediately hospitalized.

Precursors of disease development

A couple of years before the development of an acute form of mental disorder, signs of pathological processes in the body may already appear. If you pay attention to them in time, then acute attack can be prevented by providing the patient with timely medical care.

Frequently recurring depressive states, feelings of anxiety. Headaches, night cramps calf muscles, dizziness, aches (or pulling painful sensations) in the legs over time can develop into Korsakoff psychosis. Characteristic harbingers are also: darkening in the eyes (or, on the contrary, “sparks”), unevenness and unsteadiness of gait, especially after drinking alcohol.

Additional factors provoking the development of the disease are usually severe somatic diseases or injuries that deplete the body's potential.

Causes of Korsakov's psychosis

The main cause of this psychotic pathology is acute shortage B vitamins. Alcoholics most often fall victim to the disease precisely because alcohol gradually destroys the intestinal mucosa, as a result of which food is not absorbed properly, which means a deficiency of essential vitamins is inevitable.

Doctors also name among the common causes of the disease:

Severe poisoning of the body.
Head injuries, operations on the temporal lobes of the brain.
Acute forms of cerebral hypoxia.
Systematic violation of the principles of good nutrition.
Past hepatitis or other liver diseases, gastritis, a number of infectious diseases.

Medical diagnostics

For effective treatment It is important to distinguish Korsakoff psychosis from other forms of mental disorders with similar symptoms.

Among mental disorders caused by alcohol consumption, psychosis (when the patient's brain cells die) must be differentiated from delirium tremens and alcoholic dementia.

Since Korsakov’s psychosis can be provoked not only by alcohol, the prescribed treatment will differ in cases where the cause of the disease lies in other causes of damage to the human nervous system.

Medical diagnostics must include:

General examination of the patient.
Blood tests (in particular, the level of thiamine in the body).
Monitoring liver function (enzyme analysis).
Checking for possible motor coordination disorders.
Research into the functioning of the brain (limbic system).
Testing for possible violations memory, level of memorization and adequate processing of information.

Only full diagnostics allows you to take into account all clinical picture and appoint correct treatment. Remember that often the patient does not realize the abnormality of his condition and cannot seek medical help himself.

Therapy for Korsakoff psychosis

Depending on the symptoms, treatment combines methods of psychiatry, narcology and neuropathology. The acute form of Korsakov's psychosis requires mandatory hospitalization.

Full complex medical measures includes:

the patient’s complete refusal to drink alcohol;
detoxification: removal, removal of toxic substances from the body in combination with the introduction of doses of thiamine;
antipsychotics for the relief of acute psychotic disorder;
antidepressants to relieve anxiety;
nootropic drugs to stimulate brain function;
special diet with increased content squirrel;
psychocorrection sessions, the purpose of which is to restore the patient’s full social life and prevent possible returns to a pathological lifestyle;
a course of vitamins (especially vitamin B);
physical therapy, massage to eliminate muscle atrophy and paralysis.

Cure possibilities

With systematic drunkenness, Korsakoff psychosis can develop quite quickly, and sometimes take decades to recover. Returns to alcohol abuse quickly nullify the efforts of doctors to rehabilitate a sick person. In such cases, the scale of brain damage often leads to dementia, and in acute forms illness and death are possible.

Younger patients who are ready to completely give up drinking alcohol have a favorable prognosis for full recovery after a mental disorder. If the case of the disease is not severe, then within a year there is a possibility of complete recovery of memory and nervous activity body. Of course, this requires full treatment and persistent refusal to drink alcohol.

Korsakoff psychosis is accompanied by a lack of vitamin B1 (thiamine) in the human body

In any case, mental disorder is easier to prevent than to cure. The right image life without bad habits, vitamin-rich diet and peace of mind are the best prevention many diseases, including mental disorders.

Much has been said about the dangers of alcohol. Dependence on alcoholic beverages deprives a person of normal socialization, destroys family relationships, and leads to mental degradation of the patient. Treatment of this disease is not easy and does not always bring the desired result. And the harm caused by alcohol to the human body is simply irreparable. One of the most deplorable consequences of alcoholism is Korsakov psychosis.

Origin of the disease

You can often find information that this disease occurs as more late complication Wernicke encephalopathy, if the primary diagnosis has not been treated. Therefore, first you should understand what Wernicke encephalopathy is and why it occurs.

Wernicke encephalopathy is a brain disorder caused by a lack of thiamine (vitamin B1) in the body. Acute deficiency of this vitamin most often occurs with alcoholism, although sometimes there may be others serious reasons: AIDS, malignant tumors, constant vomiting or systematic fasting. Symptoms of Wernicke's encephalopathy include confusion, disorientation and apathy, and disorders of the functioning of the optic nerves.

Experts note that this disease is extremely serious, about 15-20% of patients die, and not even from thiamine deficiency, but for the reason that under these conditions the body is unable to resist the slightest infection. However, even with such a serious illness, people dependent on alcohol do not always rush to treatment. In the absence of proper therapy, a later complication develops – Korsakoff psychosis.

Development of Korsakoff psychosis

This disease is named after the scientist S.S. Korsakov, who was the first to describe this condition in his dissertation “On Alcoholic Paralysis” in 1887. In his work, the author first called this disease polyneuritic psychosis. Typically, Korsakoff psychosis develops with severe alcoholism, after for long years alcohol abuse. Moreover, by the time of diagnosis, such a patient’s medical history often already includes delirium tremens (delirium tremens), hepatitis and gastritis.

The average age of patients diagnosed with Korsakoff psychosis is usually more than 30 years, and women are more likely to develop this complication than men.

Experts note that even before the typical symptoms of this disease appear, warning symptoms first appear (usually 1-2 years in advance). This manifests itself as aches, aching pains and cramps in the legs (especially at night). Headaches and dizziness also occur, the patient feels that his eyes are “darkening” or “sparks are in his eyes.” The gait also changes, becoming uncertain and unsteady, especially in a hangover.

The patient's intelligence decreases, the range of his hobbies and interests is significantly narrowed. Sleep disturbances occur and nightmares may occur. And in daytime Multiple fears and anxiety arise.

These are the harbingers that precede the manifestation of Korsakov's psychosis. If no treatment has been started, over a period of 1-2 years it develops serious illness. The trigger is usually a viral infection or any somatic disorder. For a weakened and exhausted body, this is already enough for serious complications to begin.

Symptoms and treatments for Korsakov's psychosis

On initial stage Korsakov's psychosis occurs in the same way as delirium tremens (delirium tremens). The patient is in a state of altered consciousness, does not realize his location, loses orientation in time, and sometimes experiences various auditory and visual hallucinations. Sleep is significantly disturbed, the patient practically does not sleep. Subsequently, the person’s consciousness gradually clears up, hallucinations recede, and they remain on their own. typical symptoms Korsakov psychosis. These include:

Fixation amnesia. It is a specific memory disorder when the patient is unable to remember current information, but all memories from an earlier time are preserved. For example, a person whom the patient meets may repeat his name many times, but the patient cannot remember it and constantly asks again and again. At the same time, he perfectly remembers all the members of his household and even his old school friends.
Confabulation. These are, in fact, fictions with the help of which the patient tries to hide his memory impairment. This is especially evident when trying to ask him what he did and where he was today or yesterday. The patient makes up all sorts of stories that are completely untrue. They are called confabulations.
Amnestic disorientation. It occurs due to the first symptom (fixation amnesia). As a result of problems with memory for recent events, the patient becomes disoriented in space and time. For example, he cannot understand where he is, cannot answer what day, month or year it is. At the same time, old skills and memories are well preserved.

Korsakoff psychosis occurs as chronic illness and can last for many months and even years. With long-term rehabilitation, after a long time the patient’s condition may change for the better.

1 year ago

Korsakov's syndrome (amnestic) is a pathopsychological depression of the human body, which is most often caused by prolonged use of alcoholic beverages. A progressive disease is expressed in a person by short-term loss of memory of recently occurring events, while the person remembers long-standing stories well.

Korsakoff syndrome is dangerous to health, since not every person, especially if he drinks strong drinks, can endure the symptoms of the disease. Treatment is prescribed to the victim after diagnosis and identification of the type and classification of the disease. Alcohol amnestic syndrome takes much longer and is more difficult to treat than non-alcoholic amnestic syndrome, since alcohol greatly destroys the human body, his brain, and also has a detrimental effect on emotional condition personality.

Korsakoff syndrome causes the following amnestic disorders to the patient:

amnesia of the anterograde type - the patient cannot remember most of the events that develop after the onset of the disease, but memory reproduces past events well;
amnesia of the retrograde type - the patient cannot remember long-standing events of his own life with which it was filled before the development of pathology;
fixation type amnesia - a person is unable to remember life events that occurred 5-10 minutes ago (this is considered the most difficult form Korsakov's syndrome);
disorientation of the amnestic type - in this case the patient experiences complete disorientation in space, time and environment (this phenomenon is considered a consequence of the development of fixation amnesia).

Korsakov's amnestic syndrome also has paramnestic disorders. These include:

confabulation - the patient talks about recent events with fiction and lies (in other words, he simply invents his past life, since he does not remember it);
cryptomnesia - in this case, a person confuses the sources of development of certain events occurring in his life (for example, whether he is the author of a novel or simply read it before);
pseudoreminescence - the inability to remember the time of events that happened to a person (for example, the patient may forget that he walked with an acquaintance yesterday - in this case, he will believe that it happened a long time ago).

The treatment of the victim depends on the classification of the disease, so before prescribing complex treatment will definitely need to be carried out diagnostic measures, as well as identify the symptoms of the disease and the causes of its occurrence.

Alcoholic Korsakov psychosis

Korsakoff psychosis of the alcoholic type appears as a result of drinking large amounts of alcohol, which leads, first of all, to memory loss or disorientation of the person. Also, alcoholic beverages can cause other phenomena in strongly or mildly expressed forms.

These include a decrease in the patient’s passive attention, lack of normal and healthy perception new information, and also there is a superficial direction of the personality, which leads to the occurrence of rash actions. The patient’s mood initially shows signs of euphoria from drinking alcohol, but if he takes strong drinks for more than 3-5 months, the person will turn into a gloomy and indifferent alcoholic who will need to be saved from mental illness. After all, it is known that alcohol negatively affects the human psyche, greatly depressing the patient’s condition and causing dependence on alcohol.

Attention! Frequent and long mental stress leads to fatigue of the drunkard, which has an extremely negative impact on the emotional background of a person.

Sometimes memory loss occurs in the victim alcoholic products so strong and deep that the information just received, be it good or bad, is immediately forgotten. In this case, people live in the past because new memories are not retained in the head.

This condition is dangerous for alcoholics, because they can easily mistake non-existent information for reality - this greatly traumatizes the psyche of an already sick person.

Typically, Korsakov's syndrome caused by alcohol intake leads to loss of space, time and location, while the victim's autopsychic orientation is not impaired.

Non-alcoholic Korsakoff psychosis

Amnestic syndrome can be caused not only by alcohol intake. However, today many consider strong drinks to be the culprits in the development of the disease. Skull injuries and other diseases can also lead to the development of Korsakoff syndrome, but this happens extremely rarely. Treatment of non-alcoholic type syndrome is carried out according to a completely different scheme, therefore, before prescribing complex therapy it is important for the doctor to put correct diagnosis, based on the cause of the disease.

Along with the cause of the disease, patients experience various symptoms pathology. Depending on the age of the victim, the symptoms of the development of non-alcoholic Korsakoff syndrome are as follows:

older people, when the disease develops, suffer from apathy, and they also experience a disturbance in time orientation;
in children, signs of the disease are very rare - they consist of forgetting events that happened quite recently;
Middle-aged people, after the development of pathology, are in a euphoric state, but as it ends, it turns into severe memory loss - this causes forgetting of the events that are happening Lately In human life.

Non-alcoholic psychosis is cured much faster, since during its development there is no disruption of the emotional background and body systems by the breakdown products of alcohol. After diagnosis, doctors need to prescribe the correct treatment, which will help restore brain activity.

Clinical manifestations

Korsakov's syndrome has specific manifestations. These include:

the onset of disorientation in space or time;
memories that didn't actually exist;
development of fixation type amnesia.

Fixational amnesia prevents a person from remembering events that are currently happening in his life. As a result, patients cannot remember who they met 10 minutes ago and what they talked about. Korsakoff psychosis is often accompanied by repetition of the same actions by the affected person. For example, he can read a book on one page several times, constantly say hello to one person on the street, or redo his due tasks several times.

When the syndrome develops, memory for words suffers especially severely, and to a lesser extent the patient forgets his own emotional state. Along with this, a person can easily remember a long-standing life event that happened to him before the development of pathology. Thanks to this characteristic It is possible to identify Korsakoff psychosis, as well as its type, quickly, because a person’s memory is unique - it must remember events that have recently occurred, and slightly erase those that happened a long time ago. If in a person this phenomenon occurs the other way around, this is considered the main sign of the development of psychosis.

If Korsakoff's syndrome is characterized by disorientation, the patient cannot remember today's date, the place where he is, and is also unable to distinguish the time of year. In advanced cases, people are unable to remember how the rooms and furniture are arranged in their apartment. This condition mainly develops in alcoholic patients, while disorientation is observed in people whose disease is not caused by drinking strong drinks.

Manifestations of Korsakoff's syndrome

What manifestations will help a person and his loved ones understand that he is developing Korsakoff syndrome? These include:

decrease in human activity and will;
impairments associated with the intellect, which leads to the inability to adequately evaluate one’s own actions;
depression of the body’s state, as a result of which the patient does not want to do the usual activities that previously brought him joyful moments.

Korsakoff's syndrome also manifests itself in the victim's false memories, which he tells in the form of previously occurring moments of his own life. These include:

passing off heard information as reality;
replacing events that just happened with those that happened long before the illness;
supplementing real events with fictitious ones, which ultimately creates a “low-quality” picture and a fictitious illusion of the patient’s life.

False memories occur in 50% of patients, as evidenced by modern statistics. Unfortunately, they greatly aggravate the patient’s life, because due to fantasies and imaginations, it seems to him that everything is fine, although in reality this is not the case at all. Such people refuse to be treated, which can have an extremely negative impact on their health.

Memory impairment and paramnesia

Korsakov's psychosis syndrome, accompanied by false memories (paramnesia) or impaired memory functioning, develops as a result of a lack of thiamine and nicotinic acid in the patient's body. main reason their deficiency is the intake of large doses of alcohol. Also, their smaller number may be due to infectious diseases, poisoning or skull injuries that cause brain damage.

It is known that alcoholism in 80% of cases leads to worsening brain function and also causes mental damage. Therefore, paramnesia and memory impairment are a common occurrence in actively developing Korsakoff syndrome.

Important! According to doctors, amnestic syndrome develops in alcoholics only if alcohol for a long time had a detrimental effect on the human psyche. If according to certain reasons this did not happen, the disease is unlikely to develop in an alcohol abuser.

Forecast

The prognosis of Korsakoff syndrome is considered favorable and quickly curable if the disease began to develop as a result of trauma to the brain, skull, or subarachnoid hemorrhage. The worst thing for the patient is if the disease begins its active development after a heart attack or during a lack of thiamine in the body. In this case, the victims require hospital treatment.

Attention! Even with proper adherence to the treatment regimen, only 20% of patients are completely cured of Korsakoff syndrome. The treatment will positive result on the health of patients after 12-24 months, during which treatment should proceed in full. First, the therapy will take place in a hospital, after which the person will need to take medications at home, as well as visit sanatoriums every six months.

Causes

Korsakoff syndrome develops for the following reasons:

insufficient amount of vitamin B in the body - if the disease is caused by drinking alcohol, it is important to know that alcoholic drinks washed away useful material and vitamins from the body that enter it with food;
head injuries;
thiamine deficiency;
performing surgery in the temporal lobe;
some types of infectious diseases;
frequent poor nutrition;
serious poisoning.

These reasons are considered the main ones in the development of the disease, so doctors pay attention to them Special attention when making a diagnosis.

Symptoms

Korsakoff syndrome can manifest itself several years before development. Symptoms this state are:

pain in the lower extremities;
darkening of the eyes;
pain in the calves;
aches;
unsteady gait;
pain in the head and temporal region;
night sweats;
narrowing the range of possibilities and loss of interest in life;
anxiety.

Such symptoms will help a person understand that he may develop Korsakoff's syndrome in the near future. Therefore, treatment measures can be taken after detecting signs of the disease. If alcohol intake is to blame, you should stop drinking it.

Problems that can lead to psychosis:

liver pathologies;
colitis;
injuries of various types.

The first symptoms of the disease are:

disturbance of consciousness;
disorientation;
forgetting important points life (for example, that the patient has children or a family);
listening to an otherworldly voice;
I see monsters and other creatures from fantasy.

Depression and sleep disturbances are also considered signs of the development of the disease, so they should not be excluded from view.

Diagnostics

Korsakoff syndrome can be identified using the following measures:

word memorization test;
general examination of the patient;
voluntary memorization of information;
determination of structural deficit of the medullary column;
impaired eye movement;
damage to the limbic structure.

The main diagnostic procedure is memory problems caused by alcoholism.

Treatment

Korsakoff psychosis, or rather, its therapy is aimed at removing the cause of the disease (often alcoholism is considered to be it). Most often, treatment of the disease consists of introducing a high dose of thiamine and other vitamins into the body. The patient will also need:

pharmacotherapy;
structuring space;
suppression of anxiety states.

In case of pronounced psychosis, you can take antipsychotics, but it is better to avoid medications for memory restoration, since they will be ineffective.

Prevention

To prevent Korsakoff's syndrome from developing, you need to follow some preventive rules:

treat all diseases on time;
try not to use a large number of alcohol;
maintain proper nutrition;
take vitamins.

By observing prevention, it will be possible to avoid the disease, as well as protect the body from Korsakoff psychosis, which poses a serious danger to health.

Korsakov's psychosis (alcoholic polyneuritic psychosis) is a disorder mental state appearing in the background. The disease is accompanied by damage to the peripheral nervous system, neurological symptoms, persistent memory impairment.

The disease occurs in 5% of people suffering from alcoholism, most often after the age of 45.

Korsakoff psychosis in alcoholism is a severe pathology: it is important to promptly identify symptoms and carry out treatment, otherwise mental disorders lead to organic brain damage with subsequent fatal which occurs within 1-2 years.

Reasons for the development of the disease

Korsakoff psychosis occurs as a result of prolonged use of alcoholic beverages, for 10-15 years, usually at stage 3 of alcoholism.

Signs chronic disorder psyches arise after acute conditions, such as either .

Narcologists are inclined to unanimous opinion, that with persistent alcohol addiction predisposing factors for the development of Korsakoff syndrome are various injuries, in particular the head, as well as diseases of the digestive system and liver.

It is believed that the cause of development psychotic disorders is a deficiency of vitamin B1 (thiamine) and B3 (nicotinic acid), caused by long-term use alcoholic drinks in large quantities.

Lack of vitamins and minerals in the body occurs against the background of disturbances in the normal functioning of the digestive organs. Vitamin deficiency leads to bilateral damage to the limbic system (brain structures).

Symptoms of Korsakoff psychosis

Korsakoff syndrome in alcoholism develops over several years.

The first symptoms appear in the form of body aches, periodic aching pain in the lower extremities and sensitivity disorders (goosebumps, sudden burning and tingling).

Further clinical manifestations are as follows:

Impaired, unsteady gait (most pronounced one day after drinking alcohol.
The expression of interest in everyday affairs and the surrounding world decreases, insomnia and nightmares develop.
Anxiety and fears arise for no reason.

This symptomatic complex lasts for one to two years, after which alcoholic delirium develops: delirium, auditory and visual hallucinations, in some cases leading to death, the condition is accompanied by chills and increased temperature regime bodies.

Memory disorder is one of the symptoms of Korsakov psychosis

The further development of Korsakoff psychosis is characterized by characteristic symptomatic signs:

memory decreases, over time the patient cannot remember the events that preceded the disease, then the ability to perceive new information, as well as remember it, is lost;
over time, memory for recent events is lost (the patient is already in the evening unable to remember the events that happened to him on the same day in the morning);
the patient understands and is aware of the presence of memory problems, but tries to hide this fact from others;
Inflammation of the peripheral nerve almost always occurs lower limbs, which is manifested by decreased sensitivity, muscle weakness in the affected area and a feeling of pain along the location of the nerve;
paralysis and paresis appear together with a decrease in the volume of muscle fibers;
intellectual and thinking abilities deteriorate;
progression of the disease leads to dementia, with a malignant course pathological changes in the cerebral cortex lead to the death of the patient.

Diagnosis and treatment

Diagnosis of amnestic syndrome in alcoholism includes the collection of anamnestic data, often a survey of the patient’s relatives, consultation with a psychiatrist and neurologist.

If there are any malfunctions internal organs and systems are examined by specialists - a cardiologist, gastroenterologist and others, depending on the nature of the pathology.

To determine the state of the central nervous system, magnetic resonance imaging or CT scan head and EEG. For rate general condition General and biochemical tests are carried out.

Therapeutic measures

During the period of acute clinical manifestations The patient is treated in an inpatient department by specialized specialists - a narcologist and a psychiatrist.

Treatment consists primarily of, including medicinal tinctures with alcohol. As a rule, with mental disorders the patient needs care.

During hospital treatment medical workers provide assistance on time hygiene procedures and eating. In severe bedridden patients are carried out preventive actions to prevent the formation of bedsores.

The basis of therapy is medications, physiotherapeutic procedures and traditional methods. Physiotherapy includes the use therapeutic massage, gymnastic exercises, aromatherapy, electrosleep and others according to indications.

Medication

Timely treatment of alcoholism will help to avoid many problems, in particular damage to the structures of the peripheral and.

In order to prevent the development of alcoholism, it is recommended to completely eliminate alcoholic beverages from life, especially for patients who are at high risk.

Video: Alcoholism. Amnesia. Korsakov's amnestic syndrome

Korsakov's psychosis (Korsakov's amnesia) is a type of alcoholic psychosis, which is characterized by severe memory impairment coupled with polyneuritis. There are several types of alcoholic psychoses: delirium tremens (delirium tremens), alcoholic hallucinosis, alcoholic delusional psychoses, metal-alcohol psychoses that occur against the background of other mental illnesses and alcoholic encephalopathies, which include Korsakoff syndrome.

This disease was recorded as the first nosological unit in psychiatry. Based on its model, clinical nosology was subsequently built. Treatment of Korsakoff's syndrome often does not give the desired result. Psychosis has chronic course and memory recovery occurs rarely (at 2-3 years). Almost always, the disease progresses and memory disorders worsen, and intellectual impairment occurs.

This syndrome was first described back in 1887 by psychiatrist S.S. Korsakov. This disease was immediately referred to as alcoholic polyneuritic psychosis. We are talking about severe memory disorders that affect speech. This is reflected in the development of a special form of paraphasia - the substitution of inadequate words in place of necessary ones. This is due to the fact that psychosis leads to the fact that short-term memory does not transfer into long-term memory.

Reasons for development

Korsakov's psychosis occurs against the background of thiamine and nicotinic acid deficiency. The main predisposing factor is alcoholism. It may also develop due to traumatic brain injuries, poisoning and infectious diseases.

Among the main reasons Korsakoff's syndrome the following should be highlighted:

Lack of B vitamins.
Hypoxia of the brain.
Regular unbalanced nutrition.
Infectious diseases.

Developing similar condition in 80% of patients diagnosed with Wernicke encephalopathy. Korsakoff's syndrome in alcoholism appears against the background of a withdrawal state. Experts say that a deficiency of vitamin B1 and a lack of enzymes that are necessary for absorption are of great importance in the development of this pathology. nutrients in the intestinal area.

Korsakoff syndrome can occur together with Gaia Wernicke encephalopathy. These conditions develop against the background of alcoholic delirium or against the background of long-term drinking bouts. Diagnosis in this case is not difficult. IN mandatory the patient must be hospitalized.

Symptoms of the disease

Many experts recommend separating Korsakoff syndrome from psychosis. In the first case we're talking about about an amnestic nature, in the second - about the development of additional symptoms in the form of motivational, physical and affective disorders, as well as polyneuritis of the extremities. Psychoses usually develop against the background acute stage alcoholism. There is a possibility of spontaneous progression.

Symptoms of alcohol syndrome appear gradually:

Paresthesia, body aches and nagging pain in the legs.
With a hangover, unsteadiness of gait appears.
Sparks and darkening appear in the eyes.
At night, cramps appear in the calves.
Headaches and dizziness occur.

A person becomes restless, his circle of interests narrows. Symptoms are more pronounced if there is concomitant diseases liver, colitis, somatic disorders and various injuries.

At the very beginning of development, pathological process occurs in the form of alcoholic delirium, which is characterized by disturbances of consciousness, hallucinations (visual, auditory), and loss of orientation in space. After consciousness manifests itself, the development of retrograde amnesia occurs. A person has difficulty remembering anything. Patients may forget that they have children or a spouse.

You should consult a specialist already with primary symptoms, which manifest themselves in the form of headaches, depression and sleep disturbances. Psychosis combines paramnesia and amnestic symptoms.

Among distinctive features should be highlighted:

Amnestic disorientation, which is characterized by a lack of orientation in space and time. A person loses important skills and therefore cannot take care of himself.
Fixation amnesia, which is accompanied by the inability to remember events that happened recently. In this case, those events that occurred before the development of the disease may emerge. The patient cannot learn and has a bad attitude towards any changes in life.
Paramnesia, which may occur in various forms. Instead of gaps in memory, events from many years ago emerge. Information from books or TV shows can be substituted into memory.

Muscle weakness leads to rapid loss of strength. There is a violation of the sensitivity of the nerves, as a result of which the person almost completely stops responding to tactile stimuli. In some cases, paresthesia occurs, which is accompanied by the appearance of numbness. Possible depression, loss of interest in the environment and loss of time perspective. The patient experiences fears, which are characterized by obsessive states and confusion. A person's intellectual abilities are significantly reduced.

Korsakov's syndrome, which develops against the background of alcoholism, is more typical for women than for men. In men, alcoholic pseudoparalysis, which is amnestic in nature, more often develops. In this case we are talking about smoother forms.

Therapeutic measures

For appointment effective therapy must be carried out comprehensive examination, namely:

Blood test to determine thiamine levels.
Liver function testing and general examination body.
Memory Testing Using Rote Memorization and Random Testing
Determination of structural deficits of the brainstem using the study of limbic structure.
Study of coordination of movements and changes in motor activity eye.

Korsakoff psychosis has similar symptoms to dementia and delirium. That is why it is mandatory to carry out differential diagnosis, which eliminates the possibility of an erroneous diagnosis.

Treatment of alcoholic psychosis is aimed at ridding the patient of the existing addiction. At the same time, there is no point in prescribing medications whose effectiveness is aimed at improving memory. Treatment is carried out comprehensively. For therapy, the patient is referred to specialists such as a psychiatrist, neurologist and narcologist.

Treatments are carried out in outpatient setting. Hospitalization is only necessary in acute phases diseases.

Among the main therapeutic measures should be highlighted:

Detoxification of the body.
Elimination of symptoms of agitation and excessive anxiety.
Prescribing small dosages of antipsychotic drugs.
Usage nootropic drugs, stimulating the activity of brain functions.
Carrying out vitamin therapy and using psychotherapeutic correction.
Changing your diet to increase the level of protein and vitamins entering the body with food.
Intramuscular administration B vitamins.
The amount of intake of a substance such as thiamine into the body.

With the help of vitamin therapy, it is possible to completely get rid of the polyneuritic condition. In the presence of muscle atrophy and paralysis, gymnastics is prescribed. Massage and phytotherapeutic procedures.

Metabolic and detoxification therapy includes the use of large dosages of vitamins C and B, as well as nootropic substances. Piracetam and nootropil are administered intramuscularly or intravenously. Drug therapy is long-term and depends on the advanced stage of the disease.

To quickly recover after alcohol intoxication Large dosages of thiamine and other vitamins are used. Structuring the surrounding space is mandatory. Good results provides pharmacotherapy that quickly eliminates anxiety and agitation. If psychosis is present, the specialist prescribes antipsychotics.

Risk factors

Predisposing factors include ischemic stroke, tumors in the thalamic region and hemorrhage. Korsakov's psychosis is characteristic of rehabilitation period after bariatric surgery. Causes may include dieting, schizophrenia and anorexia. The pathological process can be provoked by toxicosis during pregnancy and intestinal inflammation.

Among less significant and rarely encountered provocateurs, abscesses in the peritoneal area, tuberculosis and uremia should be highlighted. It should be noted that AIDS can also cause the development of Korsakoff psychosis. Cases have been recorded where amnesia of this type was provoked by stem cell transplantation and chronic hemodialysis. The risk group includes infants who are breastfeeding and lack adequate nutrition.

Forecast

With timely treatment and competently prescribed drug therapy There is Great chance full recovery. The duration of the disease has a direct relationship with the severity of the underlying pathology. Please note that Korsakoff's syndrome is characterized by a persistent chronic nature.

If a person continues to drink alcohol, the disease usually progresses and can produce mild symptoms for decades. Positive prognosis will be only if the patient began taking measures before the age of 60. Full recovery is possible only if the patient completely abstains from alcoholic beverages and follows all doctors’ recommendations.

When carrying out treatment on initial stages disease, the patient recovers without developing side effects. Throughout the year it is possible full recovery memory and smoothing out emerging disorders.

Poor prognosis with Korsakoff syndrome may be for those individuals who are faced with the disease due to a heart attack or thiamine deficiency. In this case, there is a need for a long-term inpatient treatment, in approximately 25% of cases. About 20% of patients recover completely. Please note that you should not expect immediate improvements from the treatment.

People who, for one reason or another, have encountered Korsakov psychosis, need the help of their loved ones. Patients should not be placed in boarding homes prematurely. Only together, accepting everything necessary measures, you can cope with this disease.