How is the Korsakoff amnestic state characterized?

Updated: May 16, 2018
  • Author: Glen L Xiong, MD; Chief Editor: David Bienenfeld, MD  more...
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Answer

Confabulation represents filling in of memory gaps with data the patient can readily recall. Debate continues as to whether this action represents a deliberate attempt by patients to hide their memory deficits. In either case, confabulation is a fascinating defense mechanism. Confabulation is classically described in Korsakoff dementia, although it may be present in other dementias and does not necessarily need to be present for a diagnosis to be made.

In actual patient scenarios, the patient often greets the examiner cordially as if he or she knows the individual, despite having never met him or her. When asked about prior encounters, the patient may tell the examiner, for example, that he or she met the examiner 2 weeks ago in the hospital but does not precisely recall the topic of the conversation. The patient may then proceed to tell the examiner that currently he or she is doing well and provide a basic history about current symptoms, as well as express uncertainty about where he or she will live. However, when asked about the year and the president, the patient might reply (in many cases, without hesitation) that the year is 1955 and that the president is Dwight Eisenhower, even though the actual year is 2011 and the president is Barack Obama.

In such cases, the examiner may not have detected any deficits until specific orientation questions were asked. Other aspects of conversation generally lack specificity and/or depth.


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