What is Wernicke-Korsakoff syndrome?
Wernicke-Korsakoff syndrome is a neurodegenerative disorder caused by a thiamine (vitamin B-1) deficiency. It is commonly linked to high consumption of alcohol over a period of time, but severe intestinal problems, cancer, and malnutrition are also causes.
Experts argue whether Wernicke-Korsakoff syndrome (WKS) is two separate but linked disorders, or if it is a spectrum of a single disease state.
Some believe that Wernicke’s is the initial, onset phase and Korsakoff syndrome is the chronic, long-term state. Wernicke’s encephalopathy often leads to Korsakoff syndrome even after treatment. Wernicke’s encephalopathy involves various cognitive (thinking) and nervous system changes. When not recognized or treated early, it can lead to permanent brain damage and death.
How common is Wernicke-Korsakoff syndrome?
The disorder affects slightly more males than females and is evenly distributed between ages 30-70. Please discuss with your doctor for further information.
What are the symptoms of Wernicke-Korsakoff syndrome?
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 (hallucinations)
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes Wernicke-Korsakoff syndrome?
The number one cause of WKS is alcoholism.
The less common causes of WKS are conditions that limit nutritional absorption. Eating and nutrient absorption can be restricted by:
- Gastric bypass surgery, which makes it difficult to meet nutritional needs due to limited food portions
- Colon cancer, which can cause pain that causes you to put off eating
- Eating disorders
Alcoholism is the number one cause of WKS because people who are alcoholics generally have a poor diet. Alcohol also prevents vitamin B-1 absorption and storage.
What increases my risk for Wernicke-Korsakoff syndrome?
Please discuss with your doctor for further information.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is Wernicke-Korsakoff syndrome diagnosed?
Examination of the nervous/muscular system may show damage to many nerve systems:
- Abnormal eye movement
- Decreased or abnormal reflexes
- Fast pulse (heart rate)
- Low blood pressure
- Low body temperature
- 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 alcohol abuse.
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 (thyrotoxicosis)
A brain MRI may show changes in the tissue of the brain. But if Wernicke-Korsakoff syndrome is suspected, treatment should start immediately. Usually a brain MRI exam is not needed.
How is Wernicke-Korsakoff syndrome treated?
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:
- In a coma
Vitamin B1 may be given by injection into a vein or a muscle, or by mouth. This may improve symptoms of:
- Confusion or delirium
- Difficulties with vision and eye movement
- Lack of muscle coordination
- Vitamin B1 often 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. A well-balanced, nourishing diet can help, but it is not a substitute for stopping alcohol use.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage Wernicke-Korsakoff syndrome?
The following lifestyles and home remedies might help avoid Wernicke-Korsakoff syndrome:
- Not drinking alcohol or drinking in moderation and getting enough nutrition.
- 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.
If you have any questions, please consult with your doctor to better understand the best solution for you.
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