I am calling in Dr House and putting thiamine deficiency back on the table. Hey if people can bring in Pee Wee Herman...
Flawed but does illustrate the thiamine theory. More likely the person would reconstruct using past memories, not from arbitrary cues in front of them.
The definition of Korsakoff's Syndrome has evolved to now only describe permanent long term damage, essentially a form of dementia. It tends not be be used anymore to describe the scenario above that I am familiar with. Now, to describe the acute condition one has to use the term Wernicke Encephalopathy which has a different set of symptoms. It looks like the "normal person, short term thiamine deficiency, sudden crazy, recovers quickly" scenario I am suggesting and shown above has been marginalized by attempts to focus on long term dementia.
Thiamine levels are not particularly stable, does not have to be about long term behavior. Not about being drunk, an alcoholic, overweight, underweight. One night of heavy drinking without sufficient food puts you at risk. What was he doing in the previous day or two? Was he trying to keep his weight down and temporarily reducing food consumption to compensate for increased drinking? Having too much fun to eat enough to compensate for the drinking?
Reasonable to question whether his thiamine would have dropped enough. Usually not (otherwise there would be dozens of stories like this every day
), but if it did we have all we need.
