Heathcote Special Interests
Heathcote’s owners and staff over the years have gained significant levels of experience, knowledge and passion for caring for people who suffer from Alcohol Related Brain Damage (ARBD) such as Korsakoff’s Syndrome and Marchiafava-Bignami disease, also we have gained similar levels for those people who have acquired head injuries. Below is a brief overview of the ARBD diseases.
Korsakoff ’s Syndrome is a brain disorder that is generally associated with heavy drinking sustained over a long period of time.In recent years it was referred to as Korsakoff’s psychosis, however this is confusing as korsakoff’s has no medical psychotic symptoms.
It is caused by a lack of Thiamine (Vitamin B1), which affects the brain and nervous system. Many heavy drinkers have poor eating habits and an inadequate diet resulting in lack of essential vitamins. Alcohol can also cause the stomach lining to inflame making it harder for the body to absorb these essential vitamins.
Korsakoff’s syndrome is the chronic form of Wernicke’s encephalopathy and is sometime referred to as alcohol related brain damage or dementia (ARBD). Korsakoff’s may result if Wernicke’s encephalopathy is not treated or is not detected in time. It is not easily resolved and can continue over a long period of time, even permanently. Damage occurs to small but important areas in the middle part of the brain, causing severe short-term memory loss. This memory loss is the most significant feature of the condition and many other abilities remain unaffected. This is where Korsakoff’s differs from most types of dementia, where there is often damage to a large area of the outer part of the brain. Symptoms include:
- Difficulty with taking on board new information or developing new skills
- Lack of insight into their memory loss, where even someone with significant gaps in their memory may believe that they are functioning normally
- Apathy or repetitive behaviours
- Confabulation; where someone fills out the gaps in their memory with elaborate fantasies.
Marchiafava-Bignami disease (MBD) is a rare condition characterized by demyelination of the corpus callosum. It is seen most often in patients with chronic alcoholism.
In 1903, Italian pathologists Marchiafava and Bignami described 3 alcoholic men who died after having seizures and coma. In each patient, the middle two thirds of the corpus callosum was found to be severely necrotic. Through the years, the medical literature accumulated hundreds of cases of MBD. Most of these cases were found in alcoholic men.
With the advent of computed tomography (CT) scanning and magnetic resonance imaging (MRI), more cases of MBD have been recognized than before. Analyses of such cases have revealed several patterns, including scattered lesions or cysts observed at intervals from the front to the back of the callosum. Nearby areas (eg, anterior commissure, posterior commissure, brachium pontis, other white-matter tracts) and the centrum semiovale are frequently involved.
In 2007, Celik et al reported a case of a nonalcoholic patient with acute MBD that was associated with a gynecologic malignancy. The authors raised the question of a possible paraneoplastic MBD. That same year, Rusche-Skolarus et al described a case of MBD in a postoperative, nonalcoholic female who presented with an encephalopathy.