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Korsakoff Prognosis — MRCPsych Paper B MCQ

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HardSubstance MisuseKorsakoff PrognosisMRCPsych Paper B

A 50-year-old man developed Korsakoff syndrome following inadequately treated Wernicke encephalopathy. Six months later, despite sustained abstinence, nutritional repletion and ongoing thiamine, he continues to have severe anterograde amnesia and is receiving specialist rehabilitation. His family asks about his longer-term cognitive prognosis. Which statement is most accurate?

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Reveal the answer and explanation

Correct answer: A — Severe amnesia often persists, although partial cognitive and functional gains may continue for two to three years with abstinence and rehabilitation

Explanation lettering: B = shown as A · C = shown as B · D = shown as C · A = shown as D

B is correct. Established Korsakoff syndrome commonly leaves enduring anterograde amnesia, but it should not be described as universally or immediately irreversible. With sustained abstinence, adequate nutrition, ongoing prevention of thiamine deficiency and structured rehabilitation, partial cognitive and functional improvement may continue over two to three years; some patients nevertheless require long-term support. Thiamine is essential but does not reliably reverse established amnestic brain injury, so A is too optimistic. C incorrectly imposes an early ceiling on recovery. Improvement does not exclude Korsakoff syndrome, making D false. Unlike a neurodegenerative dementia, Korsakoff syndrome is generally stable rather than inevitably progressive when abstinence and nutrition are maintained, so E is incorrect.

Reference: Royal College of Psychiatrists. Alcohol, mental health and the brain, sections 'Korsakoff’s Syndrome' and 'Can I recover from alcohol-related brain damage?'; current webpage, accessed 19 August 2026. https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/alcohol-mental-health-and-the-brain?searchTerms=Special+Week