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Can Korsakoff's syndrome be misdiagnosed as frontotemporal dementia?

May 25, 2012

A loved one was diagnosed a year ago with frontotemporal dementia. However, he was abusing alcohol at the time, and after a year without alcohol, he seems to have recovered most of his original personality. Could he have been misdiagnosed? Is an alcohol-induced dementia permanent and does it resemble frontotemporal dementia? Could more tests confirm or refute the original diagnosis? Is a craving for alcohol part of the dementia? Are leg, arm, and jaw twitches part of the dementia, or part of the alcohol abuse?

Wow! The amazing recovery you describe is not typical of frontotemporal dementia, which is usually a fast-moving, progressive illness. I'm not a physician, but if your loved one is better after a year, I think your suspicion about a wrong initial diagnosis is correct.

Alcohol-related alcoholic dementia, also known as Korsakoff's Syndrome, is characterized by amnesia, volatile mood changes, and balance problems that can lead to falls and head injuries. Korsakoff's can't be diagnosed until a person has been sober for several weeks. Some symptoms may be reversed if the person abstains from drinking and corrects the Vitamin B-12 deficiency that is part of this diagnosis.

I think now would be an excellent time to revisit the dementia diagnosis with your family member's doctor. If he has suffered falls, you might request a brain scan to check for subdural hematomas or other issues. You can also raise your questions about alcohol cravings and muscle twitches. A craving for alcohol can be part of frontotemporal dementia and is one reason why it is sometimes misdiagnosed as alcohol-related dementia. Twitching can be associated with later stages of both diagnoses, so I'll leave it to your doctor to explore that question.

Some evidence has suggested that a little bit of alcohol every day is actually good for the brain. Sadly, too much alcohol can lead to dementia.

Good luck in your situation and as the old saying in recovery programs goes, take your life “one day at a time.”

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