A patient with chronic alcoholism presents with severe memory problems. Which of the following features is most characteristic of Korsakoff syndrome?

Appeared in: INI-CET EXAM -2026

Explanation

Korsakoff syndrome is fundamentally a chronic memory disorder, or an 'amnestic syndrome'.
Its cardinal feature is severe anterograde amnesia, which is the inability to create new memories after the onset of the disorder.
Patients also experience significant retrograde amnesia, which is the loss of memories from before the disorder's onset.
Unlike in Wernicke's encephalopathy, the patient with Korsakoff syndrome is typically alert and responsive, making the memory deficit the most prominent and defining feature.

Option B: Loss of personal identity is not a characteristic feature of Korsakoff syndrome. While memory is severely impaired, the individual's sense of self generally remains.
Option C: Korsakoff syndrome primarily affects explicit (conscious) memory. Implicit (unconscious) memory, which involves skills and procedures like riding a bike, is often relatively preserved.
Option D: This triad of symptoms—confusion, unsteady gait (ataxia), and eye movement paralysis (ophthalmoplegia)—is the classic presentation of Wernicke's encephalopathy, the acute and reversible precursor to Korsakoff syndrome.

Clinical Relevance

Nursing practice connection: Use the key finding related to The key clinical features differentiating Korsakoff syndrome from Wernicke's encephalopathy to guide bedside assessment, documentation, and the next nursing action.
Recognizing the signs of Wernicke's encephalopathy is a critical nursing responsibility, as immediate administration of high-dose intravenous thiamine can prevent the progression to irreversible Korsakoff syndrome.
Nursing care for patients with Korsakoff syndrome involves creating a safe and structured environment, using memory aids like calendars and notes, and providing nutritional support to address underlying deficiencies.
What if the patient presented with the symptoms in option D (confusion, ataxia, ophthalmoplegia)? The immediate nursing priority would be to anticipate and facilitate emergency treatment with IV thiamine, not just manage memory issues.

How to Approach the Question

First, identify the core concept of the question: the 'most characteristic' feature of Korsakoff syndrome.
Recall that Wernicke-Korsakoff syndrome has two distinct stages: an acute phase (Wernicke's) and a chronic phase (Korsakoff's).
Analyze the options to see which ones describe the acute phase versus the chronic phase.
Option D lists the classic triad of Wernicke's encephalopathy (acute).
Option A describes severe anterograde amnesia, which is the hallmark of the chronic Korsakoff syndrome.
Since the question asks about Korsakoff syndrome specifically, select the option that describes its primary, chronic feature.

Concept Tested & Keywords

Concept Tested: The key clinical features differentiating Korsakoff syndrome from Wernicke's encephalopathy.
Stem keywords: chronic alcoholism, severe memory problems, Korsakoff syndrome
Lead-in keywords: most characteristic
Clinical cues: The patient's history of chronic alcoholism is a major risk factor for thiamine deficiency, which underlies Wernicke-Korsakoff syndrome.

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E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 893-895

E6 Psychology Morgan King 9e Part 1 p. 227-229

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