Wernicke-Korsakoff syndrome is a brain disorder due to
Korsakoff psychosis; Alcoholic encephalopathy; Encephalopathy – alcoholic; Wernicke’s disease
Wernicke encephalopathy and Korsakoff syndrome are different conditions. Both are due to brain damage caused by a lack of vitamin B1.
Lack of vitamin B1 is common in people with
Korsakoff syndrome, or Korsakoff psychosis, tends to develop as Wernicke symptoms go away. Wernicke encephalopathy causes brain damage in lower parts of the brain called the thalamus and hypothalamus. Korsakoff psychosis results from permanent damage to areas of the brain involved with memory.
Symptoms of Wernicke encephalopathy include:
- Confusion and loss of mental activity that can progress to coma and death
Loss of muscle coordination(ataxia)
that can cause leg tremor
- Vision changes such as
abnormal eye movements(back and forth movements called nystagmus),
double vision, eyelid drooping Alcohol withdrawal
Symptoms of Korsakoff syndrome:
- Inability to form new memories
- Loss of memory, can be severe
- Making up stories (confabulation)
- Seeing or hearing things that are not really there (
Exams and Tests
Examination of the nervous/muscular system may show damage to many nerve systems:
Abnormal eye movement
Decreased or abnormal reflexes
Low blood pressure
Muscle weakness and atrophy (
loss of tissue mass)
Problems with walk (gait) and coordination
The person may appear poorly nourished. The following tests are used to check a person’s nutrition level:
Serum albumin(relates to person’s general nutrition)
- Serum vitamin B1 levels
Transketolase activity in red blood cells (reduced in people with thiamine deficiency)
Liver enzymes may be high in people with a history of long-term
Other conditions that may cause vitamin B1 deficiency include:
- Cancers that have spread throughout the body
- Extreme nausea and vomiting during pregnancy (
hyperemesis gravidarum) Heart failure(when treated with long-term diuretic therapy)
- Long periods of intravenous (IV) therapy without receiving thiamine supplements
- Long-term dialysis
- Very high thyroid hormone levels (
The goals of treatment are to control symptoms and to prevent the disorder from getting worse. Some people may need to stay in the hospital early in the condition to help control symptoms.
Monitoring and special care may be needed if the person is:
Vitamin B1 may be given by injection into a vein or a muscle, or by mouth. It may improve symptoms of:
Difficulties with vision and eye movement
Lack of muscle coordination
Vitamin B1 usually does not improve loss of memory and intellect that occur with Korsakoff psychosis.
Stopping alcohol use can prevent more loss of brain function and damage to nerves. Eating a well-balanced, nourishing diet can help, but it is not a substitute for stopping alcohol use.
Without treatment, Wernicke-Korsakoff syndrome gets steadily worse, and can be life-threatening. With treatment, it is possible to control symptoms (such as
Some symptoms, especially the loss of memory and thinking skills, may be permanent. Other disorders related to alcohol use may also occur.
- Difficulty with personal or social interaction
- Injury caused by falls
- Permanent loss of thinking skills
- Permanent loss of memory
- Shortened life span
When to Contact a Medical Professional
Call your health care provider or go to the emergency room if you have symptoms of Wernicke-Korsakoff syndrome, or if you have been diagnosed with the condition and your symptoms get worse or return.
Not drinking alcohol or drinking in moderation and getting enough nutrition reduce the risk of developing Wernicke-Korsakoff syndrome. If a heavy drinker will not quit, thiamine supplements and a good diet may reduce the chance of getting this condition, but the risk is not eliminated.