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Korsakoff Syndrome
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
The major component of KS is called confabulation. Confabulation is a type of amnesia that occurs when a person makes up a lie in order to fill in a gap in their memory (Wyke & Warrington, 1960). Korsakoff described this particular kind of forgetting back in the 1800s: “after a long conversation with the patient, one may note that at times he utterly confuses events and that he remembers absolutely nothing of what goes on around him … on occasion, such patients invent some fiction and constantly repeat it” (Korsakoff, 1889, as translated by Victor & Yakovlev, 1955, pp. 394–406). As the quote notes, it can take an entire conversation with the person with KS before you begin to sense that anything is off with their memory, but eventually their stories can no longer hold the weight of the falsehoods.
Dementia
Published in Henry J. Woodford, Essential Geriatrics, 2022
Wernicke–Korsacoff syndrome is caused by thiamine (vitamin B1) deficiency. The Wernicke stage is usually the precursor and has the clinical characteristics of ophthalmoplegia, ataxia and delirium. The Korsacoff stage usually, but not always, follows one or more episodes of Wernicke syndrome. This is a prolonged amnesic disorder affecting the ability to form new memories. It often causes confabulation. The pathological finding is of haemorrhagic necrosis of the mamillary bodies. Marchiafava–Bignami disease is due to acute demyelination of the corpus callosum. It was first described in middle-aged Italian men who drank excessive quantities of red wine. Associated with the dementia are seizures and inter-hemispheric disconnection. In cases of alcohol-related dementia, cognition may improve, or at least stabilise, with thiamine replacement and abstinence.
Paper 1: Answers
Published in Sabina Burza, Beata Mougey, Srinivas Perecherla, Nakul Talwar, Practice Examination Papers for the MRCPsych Part 1, 2018
Sabina Burza, Beata Mougey, Srinivas Perecherla, Nakul Talwar
A. This is characterised by prominent impairment of recent memory and difficulty learning new material with preservation of immediate recall and procedural memory. Confabulation is not a prerequisite for diagnosis. (2: p.425) (14)
Confabulations in post-acute and chronic alcoholic Korsakoff’s syndrome: a cross-sectional study conducted in two centres
Published in International Journal of Psychiatry in Clinical Practice, 2022
Erik Oudman, Yvonne Rensen, Roy P. C. Kessels
Confabulations refer to the emergence of memories of experiences and events that are incorrect in place and time, or never took place at all, and that are produced unintentionally (Cooper et al. 2006; Kopelman 2015; Rensen et al. 2015). Different classifications of confabulations have been postulated (for an overview, see Schnider 2018). A widely used distinction is made between provoked and spontaneous confabulations (Kopelman 1987). Provoked confabulations represent incorrect verbal expressions to questions or situations in which an amnesic patient feels compelled to respond. They appear to be plausible and resemble the false memories produced by healthy individuals (Heidler and Eling 2015). In contrast, spontaneous confabulations often occur without any obvious trigger, and patients might act upon their ideas (Gilboa et al. 2006). Spontaneous confabulations are a relatively rare phenomenon in brain-damaged samples, often occurring in the context of a severe amnesic syndrome (Kopelman 1987).
Screening for confabulations with the confabulation screen
Published in Neuropsychological Rehabilitation, 2020
Gianfranco Dalla Barba, Marta Brazzarola, Sara Marangoni, Valentina La Corte
Confabulation is a rather infrequent sign in neurological pathologies. Nevertheless, there are scientific and medical reasons to devise effective methods of screening for confabulations. On the one hand, the study of confabulation, the production of statements and actions that are unintentionally incongruous to the patient’s history, background, present and future situation (Dalla Barba, 1993a), may provide valuable information on the functions of normal memory, such as, for example, the role of executive functions in memory (Dalla Barba, 1993a, 1993b), or of encoding and retrieval processes (Attali & Dalla Barba, 2013; Attali, De Anna, Dubois, & Dalla Barba, 2009). On the other hand, confabulation may impair the ability of patients to live independently. For example, patients may believe that they turned off the stove when they have only thought about turning it off. However, confabulation is often reported anecdotally, seldom quantified, and there are no screening tools for its evaluation in neuropsychological assessment.
The confabulation battery: Instructions and international data from normal participants
Published in Neuropsychological Rehabilitation, 2019
Gianfranco Dalla Barba, Barbara Guerin, Marta Brazzarola, Sara Marangoni, Claudia Barbera, Valentina La Corte
Confabulation is an unusual sign in neurological and in neuropsychological pathologies. The clinical and scientific interest for this phenomenon has a long although sparse history. It has been described by Korsakoff (1889) as a pathognomonic sign of the syndrome that takes his name. Thereafter a number of studies have described confabulations in several pathologies (Baddeley & Wilson, 1986; Kapur & Coughlan, 1980; Lhennitte & Signoret, 1976; Luria, 1976; Stuss, Alexander, Lieberman, & Levine, 1978; Wyke & Warrington, 1960). Overall there is an almost general agreement that confirmed or suspected damage to the frontal lobe and related structures is frequently associated to confabulations. However, some studies reported on confabulating patients not showing frontal, executive impairment (e.g., Dalla Barba, 1993a; Dalla Barba, Boissé, Bartolomeo, & Bachoud-Lévi, 1997; Dalla Barba, Nedjam, & Devouche, 2004).