Wernicke-Korsakoff syndrome | Symptoms, Causes & Treatment

Wernicke-Korsakoff

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The Wernicke-Korsakoff syndrome is a brain disorder caused by a deficiency of B1, thiamine. This B1 deficiency is very common in individuals that have alcohol use disorder. It is also seen in individuals whose bodies do not absorb food properly, known as malabsorption. This can occur in those with chronic illnesses or go through weight loss surgery such as bariatric surgery.

The Wernicke-Korsakoff syndrome is one name for two conditions that happen together. They are Wernicke encephalopathy and Korsakoff syndrome. Many doctors lump these two as the same disease, just two different stages of the disease.

It is common for Wernicke-Korsakoff syndrome to develop after symptoms of Wernicke encephalopathy go away. Wernicke encephalopathy causes brain damage in the thalamus and hypothalamus parts of the brain (lower parts of the brain). This causes permanent damage to the brain, which turns into Korsakoff syndrome.

The Wernicke-Korsakoff syndrome is seen in 1-2% of the population in the United States. It affects a few more males than females and is seen in 30 to 70 years of age. Those who are homeless, elderly living in isolation, and psychiatric patients have higher prevalence rates than the general population.

Are There Other Names For Wernicke-Korsakoff Syndrome?

Healthcare providers will refer to Wernicke-Korsakoff syndrome by a variety of other names. These include:

  • Wernicke-Korsakoff syndrome
  • WKS
  • Korsakoff syndrome
  • Gayet-Wernicke syndrome
  • Alcohol-induced encephalopathy
  • Wet Brain

What Is Wernicke-Korsakoff Syndrome?

What is Wernicke-Korsakoff Syndrome

The Wernicke-Korsakoff syndrome is a type of brain disorder that is caused by a deficiency of B-1, otherwise known as thiamine. This disorder is a combination of two different conditions that can be occurring at the same time. These are Wernicke’s Disease and Korsakoff syndrome. It is common to start to see symptoms of Wernicke’s disease first, known as Wernicke’s Encephalopathy, followed by symptoms of Korsakoff syndrome.

Symptoms of Wernicke-Korsakoff syndrome may include confusion, changes to eyes and vision, and memory impairments.

A common cause of Wernicke-Korsakoff syndrome is alcoholism. The Wernicke-Korsakoff syndrome has also been linked to deficiencies in your diet or other medical conditions that impair the absorption of Vitamin B-1.

What Is Wernicke’s Encephalopathy?

Wernicke’s encephalopathy occurs when an individual’s brain does not get enough Thiamine or Vitamin B-1. The number one cause of this is the overconsumption of alcohol. This is almost always the case.

When too much alcohol is consumed, it prevents thiamine from being absorbed in the gut; therefore, your body cannot use it properly and this increases the amount of thiamine lost through urine.

What Is Korsakoff’s Syndrome?

Korsakoff syndrome is a long-term condition caused by Wernicke’s Encephalopathy not being treated or not treated soon enough. It causes damage to the bottom part of the brain in the thalamus and hypothalamus regions. As the damage continues to occur, it becomes more and more difficult to recover from it. Since untreated Wernicke’s Encephalopathy causes Korsakoff syndrome, many individuals and healthcare providers refer to this disease as Wernicke-Korsakoff syndrome.

Is Wernicke-Korsakoff Syndrome And Wet Brain The Same?

You may hear Wernicke-Korsakoff syndrome referred to as “wet brain”. The term “wet-brain” has a certain stigma that people willfully contracted the disease. It is possible that two people can have similar drinking problems, and one will develop Wernicke-Korsakoff syndrome, and one will not. The wernicke-Korsakoff syndrome is a complex condition with many factors. It is best to avoid the term “wet brain” when referring to Wernicke-Korsakoff syndrome.

Prevalence

Researchers don’t exactly know how many individuals are living with Wernicke-Korsakoff syndrome. It is estimated about 1-2% of those living in the United States. It is less common than other diseases such as Alzheimer’s, Vascular Dementia, and Lewy Body Dementia. The Wernicke-Korsakoff syndrome can often go misdiagnosed by healthcare providers.

What Causes Wernicke-Korsakoff Syndrome?

What Causes Wernicke-Korsakoff Syndrome

A deficiency in Vitamin B-1, otherwise known as thiamine, causes Wernicke-Korsakoff syndrome. Vitamin B-1 is a vital nutrient needed to help metabolize sugar, producing energy for the brain. When your body is deficient in Vitamin B-1, it begins to kill brain cells which causes changes in the brain and cognitive impairment.

Often, Wernicke-Korsakoff syndrome is associated with chronic alcoholism because alcohol inhibits thiamine absorption within your body. Researchers are still trying to determine the association between heavy alcoholism and dementia symptoms. There may be some hereditary factors that play a role in Wernicke-Korsakoff syndrome as well. Still, the most common element in those living with Wernicke-Korsakoff syndrome is chronic alcoholism who is poorly nourished.

Malnutrition and other causes of nutritional defection may cause Wernicke-Korsakoff syndrome. These include:

  • Eating disorders
  • Cancer
  • Chemotherapy
  • Gastric Bypass
  • Kidney Dialysis conditions that deplete Vitamin B-1
  • Inability to buy healthy food
  • Failure to be able to pay for proper healthcare

What Are The Risk Factors Of Wernicke-Korsakoff syndrome?

Risk factors for Wernicke-Korsakoff syndrome are related to diet and lifestyle. Major risk factors include malnourishment and chronic alcohol misuse.

Other factors of Wernicke-Korsakoff syndrome include:

  • Inability to afford proper healthcare
  • Failure to be able to afford adequate nutritious food
  • Kidney Dialysis (reduces the absorption of Vitamin B-1)
  • AIDS. Those living with AIDS are more likely to develop conditions that lead to a Thiamine deficiency.

Symptoms And Stages Of Wernicke-Korsakoff Syndrome

Symptoms And Stages Of Wernicke-Korsakoff Syndrome

The wernicke-Korsakoff syndrome is not just one disorder. It is the combination of two different diseases.

Wernicke disorder affects the nervous system. Those living with it suffer from confusion, ocular aberrations, and the ability to perform voluntary muscle movements.

Korsakoff syndrome is a mental disorder that affects memory loss and dementia.

There are two stages of Wernicke-Korsakoff syndrome.

Stage 1: Symptoms of Wernicke-Korsakoff syndrome

The symptoms of stage 1 Wernicke-Korsakoff syndrome include the following.

  • Visual Hallucinations
  • Auditory hallucinations
  • Less effective sense of smell
  • Ocular impairments
  • Weakness of arms and legs
  • Lack of muscle coordination
  • Confusion
  • Tremors
  • Sleepy eyes

Stage 2: Symptoms of Wernicke-Korsakoff syndrome

The symptoms of stage 2 Wernicke-Korsakoff syndrome include the following.

  • Mid to severe memory loss
  • Dementia
  • Mental Disturbance
  • Confusion
  • Disoriented
  • Coma
  • Hallucinations
  • Inability to learn new tasks

How To Diagnosis Wernicke-Korsakoff Syndrome?

How To Diagnosis Wernicke-Korsakoff Syndrome

Diagnosing Wernicke-Korsakoff syndrome is not always easy. It is easily misdiagnosed. Those living with Wernicke-Korsakoff syndrome are often confused. This makes it more challenging to talk with your doctor about all the symptoms you are experiencing.

There are no specific lab tests or neuroimaging procedures that can confirm Wernicke-Korsakoff syndrome in individuals.

Experts recommend that a medical evaluation be done for cognitive changes and memory loss and include questions about alcohol use and consumption.

Diagnostic Criteria

These are guidelines for diagnosing alcohol-related dementia, not strictly Wernicke-Korsakoff syndrome.

  • Significant alcohol history over the past 5 plus years.
  • 35 drinks a week for men/ 28 for women
  • 30 to 60 days alcohol-free. To properly diagnose, those possibly living with Wernicke-Korsakoff syndrome should go at least 30 days without consuming alcohol. This allows for a more accurate diagnosis.

Suppose your healthcare provider thinks you may have a non-alcohol-related form of Wernicke-Korsakoff syndrome. In that case, they may also look at these factors.

  • Anorexia
  • Hyperemesis gravidarum
  • Severe malnutrition
  • Use of a feeding tube for an extended time without adding Thiamine supplements through IV.
  • Other disorders or surgical procedures may have affected your absorption of thiamine.

Tips For Visiting Your Doctor

You want to be sure to get the most out of your visits with your doctor. These tips may help you get the most out of your visits.

  • Know why you are seeing the doctor.
  • Write down all your questions before your appointment. This helps you remember to ask all the questions you have for your doctor.
  • Bring someone with you to your appointment. They will help you remember to ask your questions and any critical points of each visit.
  • Write down all medications, treatment options, and diagnoses.
  • Understand all new medications that are prescribed. Know their side effects to be aware of as well.
  • Ask about any new treatment options that may be available.
  • Write down all follow-up appointments. Include the date, the time, location, and the purpose of the visit.
  • Be sure to know the best way to contact your doctor if you have questions or symptoms change before your next appointment.
  • Get a care summary of your visit with your doctor.

Treatment For Wernicke-Korsakoff Syndrome

Treatment For Wernicke-Korsakoff Syndrome

If your healthcare provider thinks you may have Wernicke-Korsakoff syndrome, your doctor will recommend an IV of thiamine. This will require hospitalization. Your doctor will also monitor and treat other symptoms that you are experiencing. IV Treatments typically continue until your doctor no longer sees improvement from the treatment.

Thiamine supplements are the best and most effective way to treat common symptoms caused by Wernicke-Korsakoff syndrome.

Thiamine supplements may help treat:

  • Vision problems
  • Eye movements
  • Coordination Issues
  • Confusion

Those living with memory and cognitive problems resulting from Wernicke-Korsakoff syndrome are not as likely to see improvement without further treatment. However, fixing your Thiamine levels may prevent further damage.

To prevent the progression of Wernicke-Korsakoff syndrome, you will need to abstain entirely from alcohol and follow a well-balanced diet.

Is Wernicke-Korsakoff Syndrome Reversible?

The wernicke-Korsakoff syndrome may be a reversible condition if it is caught early enough and when treatment begins. Some individuals with Wernicke-Korsakoff syndrome may recover fully, but this is often rare. Thiamine therapy may help improve symptoms.

Can You Prevent Wernicke-Korsakoff Syndrome?

Can You Prevent Wernicke-Korsakoff Syndrome

Abstaining from drinking or drinking in moderation can help prevent Wernicke-Korsakoff syndrome and get enough nutrition. Suppose you or a loved one consumes a lot of alcohol. In that case, you can take thiamine supplements and have a healthy diet that may reduce your chance of getting Wernicke-Korsakoff syndrome, but this will not eliminate your risk completely.

Food Rich in Thiamine

Eating foods that are rich in thiamine may help prevent Wernicke-Korsakoff syndrome.

Foods rich in thiamine include:

  • Peas
  • Soybeans
  • Enriched rice
  • Lima beans
  • Yeast extract
  • Sunflower seeds
  • Pumpkin seeds
  • Chia Seeds
  • Macadamia nuts
  • Pistachio nuts
  • Pork
  • Chicken
  • Asparagus
  • Whole Grains
  • Oranges
  • Spinach
  • Milk
  • What is the Prognosis of Wernicke-Korsakoff syndrome?

Without proper treatment, Wernicke-Korsakoff syndrome will get worse and can be life-threatening. With treatment, it is possible to help manage and control symptoms. Symptoms can slow or be stopped.

What Are The Possible Complications Of Wernicke-Korsakoff Syndrome?

The possible complications of Wernicke-Korsakoff syndrome may include:

  • Alcohol withdrawal
  • Struggles with personal and social interaction
  • Injury caused by falls
  • Permanent neuropathy
  • Thinking impairment
  • Memory impairment
  • Shortened life span

What is the life expectancy of someone with Wernicke-Korsakoff syndrome?

There is no standard life expectancy for those living with Wernicke-Korsakoff syndrome. Some individuals may completely recover, while others may live with symptoms for the rest of their life, caused by brain damage by the lack of Vitamin B-1. If someone will see improvement, it is typically in the first one to two years once a diagnosis has been given and treatment begins. 10-20% of those living with Wernicke-Korsakoff syndrome will not survive if their symptoms go untreated.

Related Disorders

Wernicke-Korsakoff syndrome symptoms can be similar to others.

Leigh Syndrome is a disorder that has similar symptoms to Wernicke-Korsakoff syndrome. Leigh syndrome is a progressive neurological disorder that begins between 3 months and two years. Another form of the disease affects those in adolescence into early adulthood. Early signs of this disorder are visual disturbances followed by progressive difficulty with coordinating voluntary movements. Muscle spasms, seizures, and dementia are also seen in those living with Leigh Syndrome.

Other diseases to consider are the following:

  • Alzheimer’s Disease
  • Anoxic encephalopathy (lack of blood flow of the brain tissue)
  • Temporal lobe epilepsy
  • Concussions
  • Lewy Body Dementia
  • Herpes virus affecting the brain
  • Stroke
  • Transient Global Amnesia
  • Third Ventricle Tumor

Does My Loved One Have Wernicke-Korsakoff Syndrome?

Some symptoms that are seen in your loved one who may have Wernicke-Korsakoff syndrome include the following:

  • Lethargic
  • Drowsiness
  • Inattentive
  • Confusion
  • Vision problems
  • Muscle weakness
  • Muscles coordination issues
  • Tremors
  • Short Term memory impairment
  • Exaggerated storytelling
  • Agitation

Other acute symptoms that need to be addressed quickly with a medical provider may include:

  • Rapid heartbeat
  • Low blood pressure
  • Low body temperature
  • Hallucinations
  • Delirium
  • Stupor

If you notice any these signs, schedule an appointment with their Primary Care Doctor to discuss symptoms in order to get proper treatment.

Caring For Those With Wernicke-Korsakoff Syndrome

Caring For Those With Wernicke-Korsakoff Syndrome

If a loved one is living with Wernicke-Korsakoff syndrome, you will want to help them as much as possible.

  • Help them abstain from alcohol.
  • Help them maintain a balanced diet. Be sure it is nutritious with thiamine-rich foods.
  • Be sure that they take the physician-recommended amount of thiamine. Your loved one should take this at the recommended amount of thiamine until their healthcare provider discontinues the use of it.
  • Be sure to keep reasonable, realistic expectations.

Some of the symptoms of Wernicke-Korsakoff syndrome are not reversible. Even if your loved one stops drinking and gets the recommended amount of thiamine, they may still have the signs of Wernicke-Korsakoff syndrome. Getting proper treatment may help prevent the symptoms from worsening.

Safety

Those who are caring for individuals with Wernicke-Korsakoff syndrome should take all precautions needed to ensure the safety of their loved ones. Things you can do include:

  • Not leaving someone alone who is confused or disoriented

Memory Impairment

Those living with memory impairment issues caused by Wernicke-Korsakoff syndrome can be challenging and frustrating for their caretaker. The following tips may help.

  • Be patient and stay calm. If you are frustrated and begin to lose patience with your loved one who has Wernicke-Korsakoff syndrome, they might pick up on it and may become frustrated or angry.
  • Label things around the house. Place visual reminders around the house to help them in their environment. This can include words or pictures of where things are or notes to remind them when certain events are.
  • If your loved one living with Wernicke-Korsakoff syndrome becomes frustrated, change the subject by doing a new activity or talking about something else. Try going on a walk together or talking about an old memory you share.

How Does Wernicke-Korsakoff Syndrome Affect Your Family?

Caring for someone in your family that has Wernicke-Korsakoff syndrome or another alcohol-related dementia can be challenging for the family. Dementia symptoms can last for their entire lifetime even with proper treatment to fix Vitamin B-1 levels. Strained relationships can occur as family members care for their loved ones that are living with Wernicke-Korsakoff syndrome.

Common Struggles include:

  • Those who have a history of alcohol abuse isolate themselves from their family.
  • Caregivers may feel resentful caring for a parent or spouse that is living with Wernicke-Korsakoff syndrome, thinking it was preventable if they would not have had a long history of alcohol abuse.
  • Those living with Wernicke-Korsakoff syndrome may struggle to give up alcohol. If this is the case, mental health professionals and healthcare providers can help.
  • Alcoholism runs in families, placing even more stress on the family.
  • Family members of those living with Wernicke-Korsakoff syndrome should reduce their alcohol consumption to help prevent Wernicke-Korsakoff syndrome.

If family dynamics and struggles continue, you may want to meet with a mental health professional who can help with your family dynamic.

When Should You Contact Your Healthcare Provider?

When Should You Contact Your Healthcare Provider

You will want to contact your healthcare provider or go to the emergency room if you have symptoms of Wernicke-Korsakoff syndrome. The sooner you get treatment, the more likely you will be able to recover from Wernicke-Korsakoff syndrome.

If you have already been diagnosed with Wernicke-Korsakoff syndrome and your symptoms worsen or return, you will want to contact your healthcare provider immediately.

Key Points Of Wernicke-Korsakoff Syndrome

  • The Wernicke-Korsakoff syndrome is a brain disorder caused by a Thiamine deficiency (Vitamin B-1)
  • The Wernicke-Korsakoff syndrome is made up of two conditions: Wernicke encephalopathy and Korsakoff syndrome.
  • The Wernicke-Korsakoff syndrome is common in those 30-70 years of age.
  • Those who are homeless, elderly living in isolation, and psychiatric patients have higher prevalence rates than the general population.
  • The Wernicke-Korsakoff syndrome is most often associated with chronic alcoholism. It can also be from malnutrition.
  • There are two stages of symptoms associated with Wernicke-Korsakoff syndrome.
  • There are no specific ways to diagnose Wernicke-Korsakoff syndrome, making it easily misdiagnosed.
  • If you are living with Wernicke-Korsakoff syndrome, your healthcare provider will often recommend an IV of Thiamine which requires hospitalization.
  • Thiamine supplements may be used to help treat Wernicke-Korsakoff syndrome. You will want to take these until your doctor discontinues their use.
  • To prevent the progression of Wernicke-Korsakoff syndrome, you will need to abstain from alcohol consumption.
  • You will want to eat foods that are rich in thiamine to help prevent Wernicke-Korsakoff syndrome.
  • It is possible to help manage and prevent symptoms from worsening with treatment.
  • You will want to seek medical care as soon as possible if you think you are living with Wernicke-Korsakoff syndrome.

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