Neuropsychological Intervention in a Case of Korsakoff's Amnesia

Abstract

T he cognitive symptoms that characterise the Wernicke-Korsakoff's syndrome include anterograde amnesia, confabulation, temporal-spatial disorientation, severe apathy, poor awareness of one's own mental state and changes in executive functions. Such deficits may persist even after the clinical profile stabilises. There are no studies that report an intervention after the acute phase, possibly due to the complexity of these cases. This study provides a descriptive analysis of neuropsychological rehabilitation concomitant to the neurological and psychiatric treatment of a woman who presented the symptoms described by Korsakoff. The intervention focused on reducing the impact caused by the cognitive and behavioural sequelae in the patient's daily life. It described a 25-week neuropsychological program, providing education and compensatory strategies for the patient, and also orientation and support from 2 professional caregivers and family members. Quantitative and qualitative measures were used to evaluate the effect of the intervention on memory efficacy, emotional state and social participation. Both caregivers reported a decrease in the frequency of memory lapses after treatment. Positive changes were also seen in self-care, activities at home, decision-making and participation in social activities. It is concluded that this case achieved results through the collaboration between members of an interdisciplinary team and caregivers providing daily support.

Interventions for alcohol-related brain damage (ARBD): Do specific approaches restrict the evolution of comprehensive patient care?

“…Memory aids and environmental modifications should also be used in the rehabilitation of ARBD, as they can improve daily functioning and may reduce the anxiety and social embarrassment associated with memory impairment (Davies & Binks, 1983;Lenanne, 1986;Morgan et al, 1990;Monteiro et al, 2011).…”

“…Nonetheless, the findings from this review indicate that a variety of psychosocial interventions are beneficial in the rehabilitation of ARBD. It is therefore recommended that practitioners should deliver structured group and individual psychosocial interventions which focus on establishing regular daily routines, such as self-care habits, regular meal times and participation in timetabled activities, within an alcohol-free environment (Lenanne, 1986;Monteiro et al, 2011;Wilson et al, 2012). Many individuals with ARBD may be socially isolated (MacRae & Cox, 2003).…”

“…However, they suggested that the provision of clear rules to individuals with ARBD during rehabilitation may reduce the incidence of preservative errors and help to structure tasks during everyday problem solving activities. Monteiro et al (2011) incorporated decision-making and initiative training within a neuropsychological intervention programme for a single ARBD patient. A graded approach was adopted using increasingly complex real-life scenarios, such as choosing clothes, establishing daily routines, grocery shopping, and bill payment.…”

“…This programme was reported to be effective in promoting positive clinical outcomes, such as reducing acute hospital admissions and relapse rates, whilst it also improved cognitive functioning and the living environments of service users. Lenanne (1986) and Monteiro et al (2011) demonstrated that the implementation of fixed daily routines, along with participation in alcohol-free recreational activities can increase levels of independence and spontaneity in individuals with ARBD. Moreover, Blansjaar et al (1992) and Irvine and Mawhinney (2008) provided evidence to suggest that specialist supported accommodation is beneficial in ARBD rehabilitation, as it facilitated independence as was associated with improvements in social, physical and behavioural functioning.…”

Case Report: Intensive Inpatient Neurorehabilitation Achieves Sustained Real-World Benefits in Severe Alcohol-Related Wernicke-Korsakoff Syndrome: A Case Study With 7-Years Follow-Up

“…To the best of our knowledge, only two case reports have addressed this issue (Monteiro et al, 2011 ; Genç et al, 2018 ), but none of them covered long-term follow-ups. In detail, one case study of a 48 year WKS patient with a history of heavy drinking, reported outcomes of inpatient neurorehabilitation (Genç et al, 2018 ).…”