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A Case of Craniopharyngioma Presenting as Korsakov's Syndrome

Published online by Cambridge University Press:  29 January 2018

G. Palmai ,
D. C. Taylor  and
Murray A. Falconer
G. Palmai
Affiliation:
The Maudsley Hospital, Denmark Hill, London, S.E.5
D. C. Taylor
Affiliation:
Guy's-Maudsley Neurosurgical Unit, De Crespigny Park, London, S.E.5
Murray A. Falconer
Affiliation:
Guy's-Maudsley Neurosurgical Unit, De Crespigny Park, London, S.E.5
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Extract

The particular mental state described by Korsakov (1890, 1891) is, in most cases, a sequel of Wernicke's encephalopathy, which itself is the result of alcoholism. Korsakov, however, also observed the same mental condition in persons, not alcoholic, who had been exposed to carbon monoxide, to phosphorus poisoning, or to profound toxic states. Within a few years, Monckenmoller (1899) and Meyer (1899) had each described the Korsakov state appearing late in the natural history of sarcomata of the sella turcica and third ventricle respectively. Delay et al. (1964) ably reviewed 108 instances in the literature of the association of cerebral tumour and Korsakov state, and concluded that cerebral tumour is most likely to lead to the Korsakov state if it leads to a bilateral lesion in the hippocampo - mamillo - thalamo - cingulate pathways, an observation previously made by Grünthal (1939), Kleist (1934), and Orthner (1957). By virtue of their possible situation, craniopharyngiomas are so placed anatomically that they are associated with the Korsakov state with disproportionate frequency compared to other intracranial tumours. However, in some of the reported cases the Korsakov features were tenuous, were a near terminal or postoperative event, or were outweighed by gross endocrine disturbances. Even so, only 3 out of 28 such cases described in the literature were diagnosed during life. Early diagnosis is thus extremely difficult, for the neurological signs are sparse and then are mainly ophthalmological, whilst the onset is insidious and accompanied by mental changes which deceptively suggest a functional basis to the whole picture.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 113 , Issue 499 , June 1967 , pp. 619 - 623
Copyright
Copyright © Royal College of Psychiatrists, 1967 

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