What are the key clinical features that differentiate Korsakoff Syndro

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Key clinical features differentiating Korsakoff syndrome from Wernicke's encephalopathy in patients with alcohol misuse:

Wernicke's encephalopathy is an acute neurological emergency characterized by the classic triad of ophthalmoplegia (eye movement abnormalities), ataxia (impaired coordination), and confusion or altered mental status. It requires urgent treatment with parenteral thiamine to prevent progression .
Korsakoff syndrome typically develops as a chronic consequence following untreated or inadequately treated Wernicke's encephalopathy. It is primarily characterized by severe anterograde and retrograde amnesia, confabulation (fabrication of memories), and relatively preserved other cognitive functions .
While Wernicke's encephalopathy presents with acute neurological signs including ocular motor dysfunction and gait disturbance, Korsakoff syndrome presents mainly with persistent memory impairment and cognitive deficits without the acute ocular or motor signs .
Wernicke's encephalopathy is reversible with prompt thiamine treatment, whereas Korsakoff syndrome often results in permanent cognitive impairment requiring long-term care support .

What are the key clinical features that differentiate Korsakoff Syndrome from Wernicke's Encephalopathy in a patient with a history of alcohol misuse?