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Wernicke-Korsakoff Syndrome- Causes, Symptoms, Effects, Treatment

Wernicke-Korsakoff syndrome is a relatively rare central nervous system complication that can develop as a result of chronic alcohol misuse and alcohol use disorder (AUD).1 It can occur due to a lack of vitamin B1 (thiamine), which is a nutritional deficit that often occurs due to prolonged and heavy alcohol misuse.2

Wernicke-Korsakoff syndrome can cause short- and long-term effects that can have a detrimental impact on a person’s life.2 However, with abstinence and proper treatment, some or all of these effects may be reversible.2 Understanding what Wernicke-Korsakoff Syndrome is, how it may result from alcohol misuse, and how to find treatment for alcohol misuse and addiction can help you to make better health life choices.

What is Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff syndrome (WKS) is a serious neurological disorder that consists of two conditions—Wernicke encephalopathy and Korsakoff syndrome.2, 5 Each condition is a different stage of the same disorder.2

Wernicke encephalopathy is the acute stage of the disease.2 It is a degenerative brain disorder that occurs due to thiamine deficiency.2 Korsakoff syndrome, which is not reversible, is the chronic stage of the disorder that can develop if Wernicke encephalopathy remains untreated.5

Although there are different potential causes of Wernicke Korsakoff syndrome, alcohol misuse and addiction are the most common causes of WKS in the US.6

Symptoms of Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff syndrome symptoms vary to a certain degree from person to person .6  People with WKS may not display all of the symptoms and some may experience certain symptoms at a greater severity than others.6

Symptoms of Wernicke encephalopathy evolve over days or weeks following a few weeks of inadequate thiamine intake. A person may experience varying degrees of:

  • Lack of energy (lethargy).5
  • Inattentiveness, lack of will, drive, and initiative.
  • Confusion and impaired memory.6
  • Double vision.6
  • Rapid, involuntary eye movements (nystagmus).6
  • Paralysis of certain eye muscles (ophthalmoplegia).
  • Drooping of the upper eyelids (ptosis).6
  • Inability to coordinate movements (ataxia).6

If treatment of Wenicke’s encephalopathy is delayed, symptoms of Korsakoff syndrome begin to emerge. Impaired memory is the predominant symptom, specifically an inability to store or retrieve recent information, as well as varying degrees of retrograde amesia. There is also a tendency to confabulate, where a person fabricates imagined experiences as a compensation for the inability to recall lost memories:2

  • Disorientation, vision problems, and lack of coordination may also still be present. And without further treatment, a person may progress to coma and death.

Causes of Wernicke-Korsakoff Syndrome

A common cause of Wernicke-Korsakoff Syndrome is a thiamine deficiency, which can occur due to alcohol misuse as well as other conditions. Thiamine deficiencies may also result in other conditions like malnutrition and liver diseases.6, 7 Thiamine is a crucial nutrient that is required by all of your tissues; it is necessary for proper brain functioning and is needed to properly convert energy from sugar.8, 9

Thiamine deficiency is common in people who chronically misuse alcohol or suffer from AUD.6 Alcohol can cause impaired absorption of thiamine from the intestine, decrease levels of stored thiamine in the liver, and negatively impact the enzyme that converts thiamine into its active state.6, 7

Without proper levels of thiamine, your brain cannot convert sugar into energy, and your brain cells will no longer function as they should.9 Thiamine deficiency also has a negative impact on the hypothalamus, which is part of the brain that is responsible for regulating body temperature, appetite, emotions, and growth.6 Thiamine deficiency can result in different types of brain damage, including but not limited to WKS.8, 9

Treatment for Wernicke-Korsakoff Syndrome

Wernicke encephalopathy is a serious, life-threatening condition that requires prompt treatment to reverse brain damage and prevent the progression to Korsakoff syndrome.7 Proper treatment can result in a full or at least substantial level of recovery, but some people may not fully recover and may require ongoing support.6

The Wernicke-Korsakoff syndrome treatment approach may vary from person to person, including the level of severity, the symptoms a person displays, and whether a person has other co-occurring disorders.5, 6

In addition to thiamine and glucose replacement, some people may require magnesium replenishment, supplementation of all B vitamins, electrolyte replacement, rehydration, and proper nutritional interventions.2, 6, 7

People with WKS are advised to abstain from alcohol to prevent further brain and nerve damage.2 Alcohol withdrawal symptoms following prolonged, heavy alcohol use will typically require medical assistance, such as detox, to prevent potentially dangerous and life-threatening withdrawal symptoms.

Entering ongoing treatment for AUD and alcohol misuse can also yield positive outcomes by helping people stop the cycle of alcohol misuse, help them develop the necessary skills and tools to remain sober, and address underlying issues related to alcohol misuse.10 No matter how bad things might seem, treatment can provide many benefits for people with AUD.10

Finding Alcohol Addiction Treatment Centers

If you or a loved one are concerned about your alcohol use or Wernicke-Korsakoff Syndrome, you may wish to consult your primary care provider to discuss your concerns, undergo an evaluation, and ask for referrals to treatment. You can also find treatment centers in your area through the Substance Abuse and Mental Health Services Administration’s website.

Addiction helplines like those operated by American Addiction Centers can also help people locate rehabs and answer questions about WKS, alcohol addiction, or the treatment process. If you or a loved one are struggling, we are here to help. Please call to speak to an admissions navigator about your rehab options and easily verify your insurance.

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