A 40-year-old chronic alcoholic man with known Wernicke's encephalopathy is treated with IV thiamine and improves. Two weeks later, he is confabulatory and has severe anterograde amnesia with inability to form new memories. He is alert and has no ophthalmoplegia or ataxia. The most likely diagnosis is:

• A Korsakoff psychosis ✓
• B Alcoholic dementia
• C Delirium
• D Dissociative amnesia

Explanation

Korsakoff psychosis (amnestic syndrome) typically follows Wernicke's encephalopathy after a period of recovery, classically presenting with anterograde amnesia, confabulation, and relatively preserved alertness without the triad of Wernicke's. It results from thiamine deficiency causing mammillary body and medial thalamic damage. The temporal relationship of improvement from Wernicke's followed by amnestic syndrome is characteristic.

Reference: Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.