The Korsakoff syndrome is defined as “an abnormal mental state in which memory and learning are affected out of all proportion to other cognitive functions in an otherwise alert and responsive patient.” Confabulation refers to false or erroneous memories arising, not deliberately, in the context of a neurological amnesia and is often thought of as pathognomonic of the Korsakoff syndrome. Although the exact pathophysiology is unknown, various studies have identified brain lesions in the thalami, mammillary bodies, and frontal cortex. We report a case of a 68-year-old male presenting with acute altered mental status on July 16, 2015. The neuropsychological dysfunctions included prominent Korsakoff's syndrome, which became apparent when the altered mental status resolved. Amnesia was accompanied by prominent confabulation, disorientation, and lack of insight into his own disability. Neuroradiological data indicated that the intralaminar and dorsomedial nuclei in bilateral thalami were infarcted by occlusion of the artery of Percheron. We believe that ours is one of few reported cases of Korsakoff syndrome in a patient with infarction involving the territory of the artery of Percheron. We conclude that bilateral thalamic lesions could cause Korsakoff's syndrome and the intralaminar and dorsomedial nuclei might be important structures in the pathogenesis of confabulation.
The COVID-19 pandemic caused by the SARS-CoV-2 virus made governments across the world announce country-wide lockdowns suspending all activities and banning travels. This affected the lives of millions of people across all the continents in the world, including South America. The low-income classes were most affected by the lockdowns as many lost their only source of income. In addition, the uncertainty of the disease and its deadly nature along with lack of access to correct information led to a deterioration of the mental health of the low-income and indigenous groups in South America. The low-income population has little chance of gaining access to proper mental healthcare as many healthcare systems collapsed due to the nature of the pandemic. A good number of them faced short-term mental effects such as anxiety and panic attacks as well as long-term effects of depression. Proper steps must be taken to maintain and help the most vulnerable sections of the population. The pandemic along with the widespread poverty-stricken regions in the country have affected the population of the country. This article assesses the impact of COVID-19 on the poor and low-income population of the South American continent and the impact it has had on their mental health. It also reviews the recommended steps that can be taken to improve the situation and help the affected people.
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