Korsakov's psychosis precipitated by convulsive seizures in chronic alcoholics

Dementia, of several types, has long been known as one of the possible fates of the alcoholic. Since Gigon and Odermatt (1925) and Shattuck (1928) called attention to the likeness between alcoholic polyneuritis and that found in beriberi evidence has accumulated of the part played by lack of B vitamins. It is now accepted that Wernicke's encephalopathy is identical with cerebral beriberi (de Wardener and Lennox, 1947) and results primarily from a deficiency of thiamine. The same brain lesions are found in Wernicke's encephalopathy and Korsakov's psychosis, allowing for the length of the illness (e.g., Victoret al., 1952; Malamud and Skillicorn, 1956) and Victor and Adams (1961) consider that Korsakov's psychosis in alcoholics is the psychic manifestation of Wernicke's encephalopathy.

The Korsakov syndrome in spontaneous subarachnoid haemorrhage

The amnestic-confabulatory symptom-complex to which the eponymous title of Korsakov's syndrome is usually given was probably first described by the Swedish physician Magnus Huss (1807–90), who spent the greater part of his lifetime in the study of alcoholism. There is, however, no doubt that Korsakov's (1890) paper on the subject gave an excellent description of the syndrome, and stressed the fact that whereas it often developed in patients with alcoholism and polyneuritis, numerous other metabolic and neurological disorders could be complicated by the characteristic mental changes. Indeed, in Korsakov's (1890) own series of cases alcoholics were in the minority. One of the neurological conditions in which the syndrome has been described significantly often is spontaneous subarachnoid haemorrhage. The first reports of the association were probably those of Flatau (1918 and 1921), and it was discussed in some detail by Goldflam (1923) and Herman (1925 and 1926). Each of these authors described the mental symptoms exhaustively but gave no actual case-histories; the first fully documented cases in the literature were the two reported by Hall (1929). Single cases have since been described by Cubitt (1930), Popow (1930) and Kulkow (1935), and in 1939 Tarachow gave an extensive review of the literature and reported an additional 3 cases. It is remarkable that since 1939 the association has received little attention, although it has been mentioned by Sands (1941) and Meadows (1951).